Disability progression markers over 6–12 years in interferon-β-treated multiple sclerosis patients

Jordi Río, Àlex Rovira, Mar Tintoré, Susana Otero-Romero, Manuel Comabella, Ángela Vidal-Jordana, Ingrid Galán, Joaquín Castilló, Georgina Arrambide, Carlos Nos, Carmen Tur, Berta Pujal, Cristina Auger, Jaume Sastre-Garriga, Xavier Montalban

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33 Citations (Scopus)

Abstract

© 2017, © The Author(s), 2017. Objective: To investigate the association between activity during interferon-beta (IFNβ) therapy and disability outcomes in patients with relapsing–remitting multiple sclerosis (RRMS). Methods: A longitudinal study based on two previously described cohorts of IFNβ-treated RRMS patients was conducted. Patients were classified according to clinical activity after 2 years (clinical cohort) or to clinical and radiological activity after 1 year (magnetic resonance imaging (MRI) cohort). Multivariate Cox models were calculated for early disease activity predicting long-term disability. Results: A total of 516 patients from two different cohorts were included in the analyses. Persistent clinical disease activity during the first 2 years of therapy predicted severe long-term disability (clinical cohort). In the MRI cohort, modified Rio score and no or minimal evidence of disease activity (NEDA/MEDA) did not identify patients with risk of Expanded Disability Status Scale (EDSS) worsening. However, a Rio score ≥ 2 (hazard ratio (HR): 3.3, 95% confidence interval (CI): 1.7–6.4); ≥3 new T2 lesions (HR: 2.9, 95% CI: 1.5–5.6); or ≥2 Gd-enhancing lesions (HR: 2.1, 95% CI: 1.1–4) were able to identify patients with EDSS worsening. Conclusion: Although early activity during IFNβ therapy is associated with poor long-term outcomes, minimal degree of activity does not seem to be predictive of EDSS worsening over 6.7-year mean follow-up.
Original languageEnglish
Pages (from-to)322-330
JournalMultiple Sclerosis Journal
Volume24
Issue number3
DOIs
Publication statusPublished - 1 Mar 2018

Keywords

  • MRI
  • Multiple sclerosis
  • disability
  • interferon-beta
  • outcome measurement
  • treatment response

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