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- Title
Clinical consequences of MRI activity in treated multiple sclerosis.
- Authors
Cadavid, Diego; Kim, Soyeon; Peng, Bo; Skurnick, Joan; Younes, Maha; Hill, James; Wolansky, Leo J.; Cook, Stuart D.
- Abstract
Background: Inflammation on brain MRI is the most sensitive marker of disease activity in multiple sclerosis (MS) but its clinical consequences remain controversial.Objective: Here we investigated the clinical consequences of MRI activity in MS subjects treated with two different first line disease modifying agents.Methods: Seventy-five treatment-naïve subjects with relapsing–remitting MS (N = 61) or clinically isolated syndromes at risk of MS (N = 14) from the BECOME study that had been randomized to interferon beta-1b (N = 39) or glatiramer acetate (N = 36) and followed for up to two years by monthly brain MRI optimized to detect inflammatory activity were studied for the clinical consequences of lack of MRI remission.Results: MRI remission occurred in 46.4% of participants transiently and in 23.2% completely while it was never achieved in 30.4%. There was no difference by treatment in MRI remission, progression of physical disability, or cognitive function. The percentage of relapse-free subjects was 87.5% for the group in complete MRI remission, 47.6% in the group never in remission and 59.4% in the group in transient remission (p = 0.017). Similar differences were observed for six-month-confirmed worsening of ambulatory function as measured by the timed 25 foot walk (p = 0.026) and by Expanded Disability Status Scale (EDSS) (p = 0.10). Cognitive function was lowest at baseline for the group that never reached MRI remission on treatment; this group improved the least upon repeated cognitive testing during the two years of treatment (p < 0.001).Conclusions: Lack of MRI remission during treatment with interferon beta-1b or glatiramer acetate is associated with higher relapse rate and worsening of physical and cognitive function.
- Subjects
MULTIPLE sclerosis treatment; MAGNETIC resonance imaging of the brain; MAGNETIC resonance imaging complications; INTERFERONS; GADOLINIUM; DISEASE progression; DISEASE relapse
- Publication
Multiple Sclerosis Journal, 2011, Vol 17, Issue 9, p1113
- ISSN
1352-4585
- Publication type
Article
- DOI
10.1177/1352458511405375