Key result
Faster global brain atrophy and/or pseudo-atrophy in the first year of treatment was predictive of an earlier time to conversion to clinically definite multiple sclerosis (HR 0.629 per unit increase).
Why the study?
It remained unclear whether the degree of inflammation and neurodegeneration after treatment initiation predicts disease progression in multiple sclerosis.
Do early MRI-derived brain and lesion volume changes predict disease progression in patients with early multiple sclerosis treated with interferon beta-1a?
Cohort (n=262)
Yes
Do early MRI-derived brain and lesion volume changes predict disease progression in patients with early multiple sclerosis treated with interferon beta-1a?
Early global brain atrophy and positive lesion activity during the first two years of interferon beta-1a treatment predict faster conversion to clinically definite multiple sclerosis.
Brain and lesion volume changes may predict MS progression; hypothesis-generating and requires prospective validation before clinical use.
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.
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Mattiesing et al. (2023) conducted a cohort in Early Multiple Sclerosis (n=262). Percentage brain volume change (PBVC) in year 1 was evaluated on Time to conversion to clinically definite multiple sclerosis (CDMS) (HR 0.629, 95% CI 0.466-0.849, p=0.002). Faster global brain atrophy and/or pseudo-atrophy in the first year of treatment was predictive of an earlier time to conversion to clinically definite multiple sclerosis (HR 0.629 per unit increase).
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