Disease progression in the first 5 years of treatment in multiple sclerosis: Predictive value of early brain and lesion volume changes
Rozemarijn M Mattiesing, Eline Kramer, Eva MM Strijbis, Iman Brouwer, Ronald A van Schijndel, Giordano Gentile, Marco Battaglini, Nicola De Stefano, Bernard MJ Uitdehaag, Frederik Barkhof, Hugo Vrenken, Menno M Schoonheim- Neurology (clinical)
- Neurology
Background:
Whether the degree of inflammation (and its resolution) and neurodegeneration after treatment initiation predicts disease progression in multiple sclerosis (MS) remains unclear.
Objectives:
To assess the predictive value of magnetic resonance imaging (MRI)-derived brain and lesion volume (LV) changes in years 1 and 2 of treatment for disease progression.
Methods:
Patients receiving early interferon beta-1a treatment in REFLEX/REFLEXION ( N = 262) were included. Predictive regression models included new/enlarging LV (positive activity), disappearing/shrinking LV (negative activity), and global/central atrophy during years 1 and 2.
Results:
Faster global atrophy and/or pseudo-atrophy and positive lesion activity in years 1 and 2 related to an increased probability and faster conversion to clinically definite multiple sclerosis (CDMS). Negative lesion activity in year 1 and slower central atrophy in year 2 were predictive of confirmed disability progression (9-Hole Peg Test). Positive lesion activity in year 2 was predictive of faster global atrophy, while positive lesion activity in years 1 and 2 was predictive of faster central atrophy.
Conclusions:
A higher degree of global atrophy and/or pseudo-atrophy in year 1 was predictive of CDMS. Positive lesion activity in any year was related to CDMS and neurodegeneration. Disability was related to negative lesion activity in year 1 and slower central atrophy in year 2.