BACKGROUND: Several predictors for treatment failure to interferon-beta (IFN-beta) have been proposed; however, brain atrophy has not been well studied. METHODS: In this prospective and longitudinal study, all consecutive relapsing-remitting multiple sclerosis (RRMS) patients treated with sc IFN-beta-1a were included. Confirmed disability progression or a new relapse between weeks 48 and 144 after beginning with IFN-beta was considered as treatment non-response. EDSS progression, relapses, number of active lesions at 1 year (new or enlarging T2-weighted plus gadolinium-enhancing lesions, categorized in > 2 or ≤ 2), and brain parenchymal fraction (%BVC) volume change within the initial year of treatment were used as predictive factors. Cox regression model was adjusted for age, gender, and disease duration. RESULTS: Seventy-one patients were included (71·8% female) with a follow-up of 144 weeks. Thirty-four (48%) fulfilled criteria of non-response to IFN-beta treatment. The model showed: (1) relapses+disability progression: HR = 4·6, 95% IC: 3·1-6·7 (P < 0·001); (2) relapses+BVC decrease: HR = 4·1, 95% IC: 3·2-7·3 (P = 0·001); (3) relapses+disability progression+new active lesions: HR = 10·1, 95% IC: 7·1-15·2 (P < 0·001); and (4) relapses+disability progression+new active lesions+BVC decrease: HR = 14·4, 95% IC: 11·4-21·2 (P < 0·001). CONCLUSIONS: Adding BVC measures to previously described predictive failure factors may increase sensitivity to early identify non-responder patients to IFN-beta-1a in the second and third years of therapy.
BACKGROUND: Several predictors for treatment failure to interferon-beta (IFN-beta) have been proposed; however, brain atrophy has not been well studied. METHODS: In this prospective and longitudinal study, all consecutive relapsing-remitting multiple sclerosis (RRMS) patients treated with sc IFN-beta-1a were included. Confirmed disability progression or a new relapse between weeks 48 and 144 after beginning with IFN-beta was considered as treatment non-response. EDSS progression, relapses, number of active lesions at 1 year (new or enlarging T2-weighted plus gadolinium-enhancing lesions, categorized in > 2 or ≤ 2), and brain parenchymal fraction (%BVC) volume change within the initial year of treatment were used as predictive factors. Cox regression model was adjusted for age, gender, and disease duration. RESULTS: Seventy-one patients were included (71·8% female) with a follow-up of 144 weeks. Thirty-four (48%) fulfilled criteria of non-response to IFN-beta treatment. The model showed: (1) relapses+disability progression: HR = 4·6, 95% IC: 3·1-6·7 (P < 0·001); (2) relapses+BVC decrease: HR = 4·1, 95% IC: 3·2-7·3 (P = 0·001); (3) relapses+disability progression+new active lesions: HR = 10·1, 95% IC: 7·1-15·2 (P < 0·001); and (4) relapses+disability progression+new active lesions+BVC decrease: HR = 14·4, 95% IC: 11·4-21·2 (P < 0·001). CONCLUSIONS: Adding BVC measures to previously described predictive failure factors may increase sensitivity to early identify non-responder patients to IFN-beta-1a in the second and third years of therapy.
Authors: Douglas L Arnold; David Li; Marika Hohol; Santanu Chakraborty; Jeffrey Chankowsky; Katayoun Alikhani; Pierre Duquette; Virender Bhan; Walter Montanera; Hyman Rabinovitch; William Morrish; Robert Vandorpe; François Guilbert; Anthony Traboulsee; Marcelo Kremenchutzky Journal: Mult Scler J Exp Transl Clin Date: 2015-06-10
Authors: Beraki Abraha; Arthur R Chaves; Liam P Kelly; Elizabeth M Wallack; Katie P Wadden; Jason McCarthy; Michelle Ploughman Journal: Front Physiol Date: 2018-07-02 Impact factor: 4.566
Authors: Jaume Sastre-Garriga; Deborah Pareto; Marco Battaglini; Maria A Rocca; Olga Ciccarelli; Christian Enzinger; Jens Wuerfel; Maria P Sormani; Frederik Barkhof; Tarek A Yousry; Nicola De Stefano; Mar Tintoré; Massimo Filippi; Claudio Gasperini; Ludwig Kappos; Jordi Río; Jette Frederiksen; Jackie Palace; Hugo Vrenken; Xavier Montalban; Àlex Rovira Journal: Nat Rev Neurol Date: 2020-02-24 Impact factor: 42.937