Background and purpose: It is still unclear which patients benefit more from available disease-modifying treatments (DMTs) in multiple sclerosis (MS). Our objective is to identify the baseline clinical and magnetic resonance imaging (MRI) predictors of response to first-line DMTs in a cohort of relapsing-remitting (RR) MS patients in a real-world clinical setting. Methods: Consecutive naïve RRMS patients treated with interferon-beta or glatiramer acetate have been included and followed for 2years. Patients were grouped into responders (R) in case of absence of clinical and MRI activity, and non-responders (NR) if the on-treatment annualized relapse rate (ARR) reduction was <50% of the ARR in the 2years before treatment or in the presence of MRI activity (≥2 active lesions at 1-year MRI or ≥4 active lesions at 1+2-year MRI). Results: At 2-year follow-up, 272 patients were R (34.6%) and 322 NR (40.9%), and multivariate analysis revealed that a later age at onset of the disease (P<0.0001), a lower disability (P<0.0001) and a lower number of gadolinium-enhancing lesions at baseline MRI (P=0.002) were predictors of efficacy of DMTs. Moreover, the first year response had a good predictive power on the second year, as 73.7% of 1-year R had no evidence of clinical and MRI activity within the ensuing year. Conclusion: A lower baseline MRI and clinical activity have been identified as predictors of DMT efficacy in patients with RRMS in routine clinical practice. Evaluation of clinical and MRI activity at 1year is recommended to monitor patients over time.

Clinical and MRI predictors of response to interferon-beta and glatiramer acetate in relapsing-remitting multiple sclerosis patients / M. Romeo, F. Martinelli-Boneschi, M. Rodegher, F. Esposito, V. Martinelli, G. Comi, B. Colombo, L. Moiola, P. Rossi, A. Poggi, M. Radaelli, E. Perego, L. Straffi, G. Liberatore, D. Dalla Libera, D. De Feo. - In: EUROPEAN JOURNAL OF NEUROLOGY. - ISSN 1351-5101. - 20:7(2013), pp. 1060-1067.

Clinical and MRI predictors of response to interferon-beta and glatiramer acetate in relapsing-remitting multiple sclerosis patients

F. Martinelli-Boneschi;V. Martinelli;
2013

Abstract

Background and purpose: It is still unclear which patients benefit more from available disease-modifying treatments (DMTs) in multiple sclerosis (MS). Our objective is to identify the baseline clinical and magnetic resonance imaging (MRI) predictors of response to first-line DMTs in a cohort of relapsing-remitting (RR) MS patients in a real-world clinical setting. Methods: Consecutive naïve RRMS patients treated with interferon-beta or glatiramer acetate have been included and followed for 2years. Patients were grouped into responders (R) in case of absence of clinical and MRI activity, and non-responders (NR) if the on-treatment annualized relapse rate (ARR) reduction was <50% of the ARR in the 2years before treatment or in the presence of MRI activity (≥2 active lesions at 1-year MRI or ≥4 active lesions at 1+2-year MRI). Results: At 2-year follow-up, 272 patients were R (34.6%) and 322 NR (40.9%), and multivariate analysis revealed that a later age at onset of the disease (P<0.0001), a lower disability (P<0.0001) and a lower number of gadolinium-enhancing lesions at baseline MRI (P=0.002) were predictors of efficacy of DMTs. Moreover, the first year response had a good predictive power on the second year, as 73.7% of 1-year R had no evidence of clinical and MRI activity within the ensuing year. Conclusion: A lower baseline MRI and clinical activity have been identified as predictors of DMT efficacy in patients with RRMS in routine clinical practice. Evaluation of clinical and MRI activity at 1year is recommended to monitor patients over time.
Glatiramer acetate; Interferon-beta; MRI; Multiple sclerosis; Relapse; Treatment response; Adjuvants, Immunologic; Adolescent; Adult; Aged; Drug Resistance; Female; Glatiramer Acetate; Humans; Interferon-beta; Male; Middle Aged; Multiple Sclerosis, Relapsing-Remitting; Neuroimaging; Peptides; Retrospective Studies; Risk Factors; Treatment Outcome; Secondary Prevention; Neurology (clinical); Neurology
Settore MED/26 - Neurologia
Article (author)
File in questo prodotto:
File Dimensione Formato  
Clinical and MRI predictors of response to interferon-beta and glatiramer acetate in relapsing-remitting multiple sclerosis patients.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 508.17 kB
Formato Adobe PDF
508.17 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/533473
Citazioni
  • ???jsp.display-item.citation.pmc??? 8
  • Scopus 27
  • ???jsp.display-item.citation.isi??? 27
social impact