BACKGROUND: Magnetic resonance imaging (MRI) of lesions in the brain may be the best current candidate for a surrogate biological marker of clinical outcomes in relapsing remitting multiple sclerosis (MS), based on its role as an objective indicator of disease pathology. No biological surrogate marker has yet been validated for MS clinical outcomes. OBJECTIVE: The objective of this study was to use a multi-phased study to determine if a valid surrogate relationship could be demonstrated between counts of contrast enhancing lesions (CELs) and occurrence of relapses in MS. METHODS: We examined correlations for the concurrent and predictive relationship between CELs over 6 months and MS relapses over the same 6 months and an additional 6 months (total: 12 months), using available data on untreated patients from a large clinical trial and natural history database. RESULTS: Concurrent and predictive correlations were inadequate to justify continuation of this study to the planned additional phases required to demonstrate a surrogate relationship between CELs and MS relapses. CONCLUSIONS: Confidence intervals for correlations between CELs and MS relapses exclude the possibility that CELs can be a good surrogate for relapses over the time scales we investigated. Further exploration of surrogacy between MRI measures and MS clinical outcomes may require improved datasets, the development of MRI techniques that couple better to clinical disease, and the ability to test a wide range of imaging- and clinically-based hypotheses for surrogacy.
BACKGROUND: Magnetic resonance imaging (MRI) of lesions in the brain may be the best current candidate for a surrogate biological marker of clinical outcomes in relapsing remitting multiple sclerosis (MS), based on its role as an objective indicator of disease pathology. No biological surrogate marker has yet been validated for MS clinical outcomes. OBJECTIVE: The objective of this study was to use a multi-phased study to determine if a valid surrogate relationship could be demonstrated between counts of contrast enhancing lesions (CELs) and occurrence of relapses in MS. METHODS: We examined correlations for the concurrent and predictive relationship between CELs over 6 months and MS relapses over the same 6 months and an additional 6 months (total: 12 months), using available data on untreated patients from a large clinical trial and natural history database. RESULTS: Concurrent and predictive correlations were inadequate to justify continuation of this study to the planned additional phases required to demonstrate a surrogate relationship between CELs and MS relapses. CONCLUSIONS: Confidence intervals for correlations between CELs and MS relapses exclude the possibility that CELs can be a good surrogate for relapses over the time scales we investigated. Further exploration of surrogacy between MRI measures and MS clinical outcomes may require improved datasets, the development of MRI techniques that couple better to clinical disease, and the ability to test a wide range of imaging- and clinically-based hypotheses for surrogacy.
Authors: Hans-Peter Hartung; Richard Gonsette; Nikolaus König; Hubert Kwiecinski; Andreas Guseo; Sean P Morrissey; Hilmar Krapf; Thomas Zwingers Journal: Lancet Date: 2002 Dec 21-28 Impact factor: 79.321
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Authors: Frederik Barkhof; Jack H Simon; Franz Fazekas; Marco Rovaris; Ludwig Kappos; Nicola de Stefano; Chris H Polman; John Petkau; Ernst W Radue; Maria P Sormani; David K Li; Paul O'Connor; Xavier Montalban; David H Miller; Massimo Filippi Journal: Nat Rev Neurol Date: 2011-12-06 Impact factor: 42.937
Authors: Stuart D Cook; Suhayl Dhib-Jalbut; Peter Dowling; Luca Durelli; Corey Ford; Gavin Giovannoni; June Halper; Colleen Harris; Joseph Herbert; David Li; John A Lincoln; Robert Lisak; Fred D Lublin; Claudia F Lucchinetti; Wayne Moore; Robert T Naismith; Carlos Oehninger; Jack Simon; Maria Pia Sormani Journal: Int J MS Care Date: 2012
Authors: Ilana R Leppert; S Narayanan; D Araújo; P S Giacomini; Y Lapierre; D L Arnold; G B Pike Journal: J Neurol Date: 2014-02-26 Impact factor: 4.849