Early magnetic resonance imaging predictors of clinical progression after 48months in clinically isolated syndrome patients treated with intramuscular interferon beta-1a
Abstrakt
Background and purposeOur 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 -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 48months.
MethodsThis study examined 210 patients. Multivariate Cox proportional hazard models were used to analyse predictors of relapse activity and confirmed disability progression after 48months.
ResultsGreater 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 48months. 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 6months 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 48months in patients with greater lateral ventricle volume enlargement between baseline and 6months (HR 4.70; P=0.001) was detected. ConclusionsA 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 6months in patients after the first demyelinating event treated with weekly intramuscular interferon -1a may assist in identification of patients with the highest risk of a second clinical attack and progression of disability.