Early magnetic resonance imaging predictors of clinical progression after 48 months in clinically isolated syndrome patients treated with intramuscular interferon β-1a

T. Uher, D. Horakova, T. Kalincik, N. Bergsland, M. Tyblova, D. P. Ramasamy, Z. Seidl, M. Vaneckova, J. Krasensky, E. Havrdova, R. Zivadinov

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background and purpose: Our aim was to identify early imaging surrogate markers of clinical progression in patients after the first demyelinating event suggestive of multiple sclerosis treated with weekly intramuscular interferon β-1a. In a prospective observational study, the predictive role of baseline and 6-month changes in magnetic resonance imaging outcomes was investigated with respect to relapse activity and development of confirmed disability progression in patients after 48 months. Methods: This study examined 210 patients. Multivariate Cox proportional hazard models were used to analyse predictors of relapse activity and confirmed disability progression after 48 months. Results: Greater T2 lesion volume [hazard ratio (HR) 1.81; P = 0.005] and the presence of contrast-enhancing lesions (HR 2.13; P <0.001) at baseline were significantly associated with increased cumulative risk of a second clinical attack over 48 months. A greater decrease of the corpus callosum volume (HR 2.74; P = 0.001) and greater lateral ventricle volume enlargement (HR 2.43; P = 0.002) at 6 months relative to baseline were associated with increased cumulative risk of a second clinical attack between months 6 and 48. In addition, increased risk of confirmed disability progression over 48 months in patients with greater lateral ventricle volume enlargement between baseline and 6 months (HR 4.70; P = 0.001) was detected. Conclusions: A greater T2 lesion volume, the presence of contrast-enhancing lesions at baseline, decrease of corpus callosum volume and lateral ventricle volume enlargement over the first 6 months in patients after the first demyelinating event treated with weekly intramuscular interferon β-1a may assist in identification of patients with the highest risk of a second clinical attack and progression of disability.

Original languageEnglish
Pages (from-to)1113-1123
Number of pages11
JournalEuropean Journal of Neurology
Volume22
Issue number7
DOIs
Publication statusPublished - Jul 1 2015

Fingerprint

Interferons
Magnetic Resonance Imaging
Lateral Ventricles
Corpus Callosum
Recurrence
Proportional Hazards Models
Multiple Sclerosis
Observational Studies
Biomarkers
Prospective Studies

Keywords

  • MRI
  • Brain atrophy
  • Clinically isolated syndrome
  • Lesions
  • Multiple sclerosis
  • Predictors

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Medicine(all)

Cite this

Early magnetic resonance imaging predictors of clinical progression after 48 months in clinically isolated syndrome patients treated with intramuscular interferon β-1a. / Uher, T.; Horakova, D.; Kalincik, T.; Bergsland, N.; Tyblova, M.; Ramasamy, D. P.; Seidl, Z.; Vaneckova, M.; Krasensky, J.; Havrdova, E.; Zivadinov, R.

In: European Journal of Neurology, Vol. 22, No. 7, 01.07.2015, p. 1113-1123.

Research output: Contribution to journalArticle

Uher, T, Horakova, D, Kalincik, T, Bergsland, N, Tyblova, M, Ramasamy, DP, Seidl, Z, Vaneckova, M, Krasensky, J, Havrdova, E & Zivadinov, R 2015, 'Early magnetic resonance imaging predictors of clinical progression after 48 months in clinically isolated syndrome patients treated with intramuscular interferon β-1a', European Journal of Neurology, vol. 22, no. 7, pp. 1113-1123. https://doi.org/10.1111/ene.12716
Uher, T. ; Horakova, D. ; Kalincik, T. ; Bergsland, N. ; Tyblova, M. ; Ramasamy, D. P. ; Seidl, Z. ; Vaneckova, M. ; Krasensky, J. ; Havrdova, E. ; Zivadinov, R. / Early magnetic resonance imaging predictors of clinical progression after 48 months in clinically isolated syndrome patients treated with intramuscular interferon β-1a. In: European Journal of Neurology. 2015 ; Vol. 22, No. 7. pp. 1113-1123.
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abstract = "Background and purpose: Our aim was to identify early imaging surrogate markers of clinical progression in patients after the first demyelinating event suggestive of multiple sclerosis treated with weekly intramuscular interferon β-1a. In a prospective observational study, the predictive role of baseline and 6-month changes in magnetic resonance imaging outcomes was investigated with respect to relapse activity and development of confirmed disability progression in patients after 48 months. Methods: This study examined 210 patients. Multivariate Cox proportional hazard models were used to analyse predictors of relapse activity and confirmed disability progression after 48 months. Results: Greater T2 lesion volume [hazard ratio (HR) 1.81; P = 0.005] and the presence of contrast-enhancing lesions (HR 2.13; P <0.001) at baseline were significantly associated with increased cumulative risk of a second clinical attack over 48 months. A greater decrease of the corpus callosum volume (HR 2.74; P = 0.001) and greater lateral ventricle volume enlargement (HR 2.43; P = 0.002) at 6 months relative to baseline were associated with increased cumulative risk of a second clinical attack between months 6 and 48. In addition, increased risk of confirmed disability progression over 48 months in patients with greater lateral ventricle volume enlargement between baseline and 6 months (HR 4.70; P = 0.001) was detected. Conclusions: A greater T2 lesion volume, the presence of contrast-enhancing lesions at baseline, decrease of corpus callosum volume and lateral ventricle volume enlargement over the first 6 months in patients after the first demyelinating event treated with weekly intramuscular interferon β-1a may assist in identification of patients with the highest risk of a second clinical attack and progression of disability.",
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AU - Horakova, D.

AU - Kalincik, T.

AU - Bergsland, N.

AU - Tyblova, M.

AU - Ramasamy, D. P.

AU - Seidl, Z.

AU - Vaneckova, M.

AU - Krasensky, J.

AU - Havrdova, E.

AU - Zivadinov, R.

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N2 - Background and purpose: Our aim was to identify early imaging surrogate markers of clinical progression in patients after the first demyelinating event suggestive of multiple sclerosis treated with weekly intramuscular interferon β-1a. In a prospective observational study, the predictive role of baseline and 6-month changes in magnetic resonance imaging outcomes was investigated with respect to relapse activity and development of confirmed disability progression in patients after 48 months. Methods: This study examined 210 patients. Multivariate Cox proportional hazard models were used to analyse predictors of relapse activity and confirmed disability progression after 48 months. Results: Greater T2 lesion volume [hazard ratio (HR) 1.81; P = 0.005] and the presence of contrast-enhancing lesions (HR 2.13; P <0.001) at baseline were significantly associated with increased cumulative risk of a second clinical attack over 48 months. A greater decrease of the corpus callosum volume (HR 2.74; P = 0.001) and greater lateral ventricle volume enlargement (HR 2.43; P = 0.002) at 6 months relative to baseline were associated with increased cumulative risk of a second clinical attack between months 6 and 48. In addition, increased risk of confirmed disability progression over 48 months in patients with greater lateral ventricle volume enlargement between baseline and 6 months (HR 4.70; P = 0.001) was detected. Conclusions: A greater T2 lesion volume, the presence of contrast-enhancing lesions at baseline, decrease of corpus callosum volume and lateral ventricle volume enlargement over the first 6 months in patients after the first demyelinating event treated with weekly intramuscular interferon β-1a may assist in identification of patients with the highest risk of a second clinical attack and progression of disability.

AB - Background and purpose: Our aim was to identify early imaging surrogate markers of clinical progression in patients after the first demyelinating event suggestive of multiple sclerosis treated with weekly intramuscular interferon β-1a. In a prospective observational study, the predictive role of baseline and 6-month changes in magnetic resonance imaging outcomes was investigated with respect to relapse activity and development of confirmed disability progression in patients after 48 months. Methods: This study examined 210 patients. Multivariate Cox proportional hazard models were used to analyse predictors of relapse activity and confirmed disability progression after 48 months. Results: Greater T2 lesion volume [hazard ratio (HR) 1.81; P = 0.005] and the presence of contrast-enhancing lesions (HR 2.13; P <0.001) at baseline were significantly associated with increased cumulative risk of a second clinical attack over 48 months. A greater decrease of the corpus callosum volume (HR 2.74; P = 0.001) and greater lateral ventricle volume enlargement (HR 2.43; P = 0.002) at 6 months relative to baseline were associated with increased cumulative risk of a second clinical attack between months 6 and 48. In addition, increased risk of confirmed disability progression over 48 months in patients with greater lateral ventricle volume enlargement between baseline and 6 months (HR 4.70; P = 0.001) was detected. Conclusions: A greater T2 lesion volume, the presence of contrast-enhancing lesions at baseline, decrease of corpus callosum volume and lateral ventricle volume enlargement over the first 6 months in patients after the first demyelinating event treated with weekly intramuscular interferon β-1a may assist in identification of patients with the highest risk of a second clinical attack and progression of disability.

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KW - Multiple sclerosis

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