A Tejeda-Velarde1,2, L Costa-Frossard2,3, S Sainz de la Maza2,3, Á Carrasco1, M Espiño1,2, C Picón1,2, I Toboso1,2, P E Walo1, D Lourido4, A Muriel5, J C Álvarez-Cermeño2,3,6, L M Villar1,2. 1. Immunology Department, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain. 2. The Spanish Network of Multiple Sclerosis (REEM), Spain. 3. Neurology Department, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain. 4. Radiology Department, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain. 5. Biostatistics Unit, IRYCIS CIBERESP, Hospital Universitario Ramón y Cajal, Madrid, Spain. 6. Medicine Department, Alcalá University, Alcalá de Henares, Spain.
Abstract
BACKGROUND AND PURPOSE: Different biological and radiological biomarkers predict clinical conversion to multiple sclerosis (MS) after a clinically isolated syndrome (CIS). The aim was to explore their role in predicting the outcome of patients with optic neuritis (ON), a CIS considered to have a benign prognosis. METHODS: Sixty-eight consecutive ON patients were followed prospectively. Magnetic resonance imaging (MRI) and cerebrospinal fluid studies including oligoclonal immunoglobulin G (IgG) bands (OCGBs), lipid-specific oligoclonal IgM bands (LS-OCMBs) and neurofilament light chain quantification were performed at disease onset. Conversion to clinically definite MS (CDMS) was monitored. RESULTS: The mean time of follow-up of our series was 46.4 months. Twenty-five patients (36.7%) developed CDMS during follow-up. Neurofilament light chain levels did not predict clinical conversion. By contrast, an abnormal MRI increased the risk of CDMS [hazard ratio (HR) 12.5, P = 0.013]. The clearest association was found in patients with more than three T2 lesions. OCGBs also predicted the onset of CDMS (HR 21.3, P = 0.003) and LS-OCMBs were associated with a shorter time to CDMS (HR = 116.6, P < 0.001). CONCLUSIONS: Magnetic resonance imaging and OCGBs predicted conversion to CDMS after an ON episode. In addition, LS-OCMBs identified the ON patients more likely to develop MS early. These results, applicable to the everyday clinical setting, may be of interest for therapeutic decisions.
BACKGROUND AND PURPOSE: Different biological and radiological biomarkers predict clinical conversion to multiple sclerosis (MS) after a clinically isolated syndrome (CIS). The aim was to explore their role in predicting the outcome of patients with optic neuritis (ON), a CIS considered to have a benign prognosis. METHODS: Sixty-eight consecutive ON patients were followed prospectively. Magnetic resonance imaging (MRI) and cerebrospinal fluid studies including oligoclonal immunoglobulin G (IgG) bands (OCGBs), lipid-specific oligoclonal IgM bands (LS-OCMBs) and neurofilament light chain quantification were performed at disease onset. Conversion to clinically definite MS (CDMS) was monitored. RESULTS: The mean time of follow-up of our series was 46.4 months. Twenty-five patients (36.7%) developed CDMS during follow-up. Neurofilament light chain levels did not predict clinical conversion. By contrast, an abnormal MRI increased the risk of CDMS [hazard ratio (HR) 12.5, P = 0.013]. The clearest association was found in patients with more than three T2 lesions. OCGBs also predicted the onset of CDMS (HR 21.3, P = 0.003) and LS-OCMBs were associated with a shorter time to CDMS (HR = 116.6, P < 0.001). CONCLUSIONS: Magnetic resonance imaging and OCGBs predicted conversion to CDMS after an ON episode. In addition, LS-OCMBs identified the ON patients more likely to develop MS early. These results, applicable to the everyday clinical setting, may be of interest for therapeutic decisions.
Authors: Caspar B Seitz; Falk Steffen; Muthuraman Muthuraman; Timo Uphaus; Julia Krämer; Sven G Meuth; Philipp Albrecht; Sergiu Groppa; Frauke Zipp; Stefan Bittner; Vinzenz Fleischer Journal: Ther Adv Neurol Disord Date: 2021-05-25 Impact factor: 6.570
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Authors: Enric Monreal; Susana Sainz de la Maza; Lucienne Costa-Frossard; Paulette Walo-Delgado; Javier Zamora; José Ignacio Fernández-Velasco; Noelia Villarrubia; Mercedes Espiño; Daniel Lourido; Paloma Lapuente; Inmaculada Toboso; José Carlos Álvarez-Cermeño; Jaime Masjuan; Luisa María Villar Journal: Neurol Neuroimmunol Neuroinflamm Date: 2021-07-22