Clinical and <scp>MRI</scp> predictors of response to interferon‐beta and glatiramer acetate in relapsing–remitting multiple sclerosis patients

Romeo, Marzia; Boneschi, Filippo Martinelli; Rodegher, Mariaemma; Esposito, Federica; Martinelli, Vittorio; Comı, Gıancarlo

doi:10.1111/ene.12119

Cited by 29 publications

(28 citation statements)

References 22 publications

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“…58 Statements and recommendations ■ T2 weighted and contrast enhanced T1 weighted brain MRI are the modalities of choice for MS disease monitoring, revealing acute and active inflammation, and clinically silent disease progression 24 Early prediction Some evidence suggests that certain baseline demo graphic variables (for example, age at treatment initi ation), clinical factors (including disease duration at treatment initiation and pretreatment relapse rate) and MRI measures related to disease activity (such as base line lesion load) can help to indicate which patients will benefit most from a first line DMD, and who will have a poor response. 66,[71][72][73][74] However, the relevant studies mainly analysed cohorts receiving different IFN β formulations, produced preliminary or inconsistent results, and have failed to satisfactorily predict treatment response in clinical practice. 70 Other MRI derived metrics-such as global or regional brain volume, or the number of spinal cord lesions-have shown value for predicting relapses or disability progression, 35-37,39,75-77 but have not been specifically analysed for treatment response predictions.…”

Section: Focal Lesionsmentioning

confidence: 99%

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—establishing disease prognosis and monitoring patients

2015

Nat Rev Neurol

405

147

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Section: Focal Lesionsmentioning

confidence: 99%

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—establishing disease prognosis and monitoring patients

2015

Nat Rev Neurol

405

147

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“…In the respective pivotal clinical trials comparing active treatment to placebo, natalizumab monotherapy reduced annualized relapse rate (ARR) by 68% [9][10][11][12][13][14][15][16] compared to an around 30% reduction for IFN-b preparations and GA. Although these trials largely enrolled treatmentnaive patients, they were conducted in different epochs resulting in different absolute ARRs (ranging from 0.73 to 1.28 in the placebo groups).…”

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confidence: 99%

Comparative efficacy of first-line natalizumab vs IFN-β or glatiramer acetate in relapsing MS

et al. 2016

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Background: We compared efficacy and treatment persistence in treatment-naive patients with relapsing-remitting multiple sclerosis (RRMS) initiating natalizumab compared with interferon-b (IFNb)/glatiramer acetate (GA) therapies, using propensity score-matched cohorts from observational multiple sclerosis registries. Methods: The study population initiated IFN-b/GA in the MSBase Registry or natalizumab in the Tysabri Observational Program, had $3 months of on-treatment follow-up, and had active RRMS, defined as $1 gadoliniumenhancing lesion on cerebral MRI at baseline or $1 relapse within the 12 months prior to baseline. Baseline demographics and disease characteristics were balanced between propensitymatched groups. Annualized relapse rate (ARR), time to first relapse, treatment persistence, and disability outcomes were compared between matched treatment arms in the total population (n 5 366/group) and subgroups with higher baseline disease activity.Editorial, page 97 *These authors contributed equally to this work.

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“…One of these researches, conducted on 272 patients to assess the response to IFN-b and GA, found that older age at diagnosis, lower basal EDSS and less Magnetic resonance imaging (MRI) activity, increased the probability of response to the treatment. 24 On the other hand, other studies do not share these findings. In a big observational study carried out in our country, the researchers did not find any epidemiological variable (sex, age at MS onset, duration of MS, and duration of GA treatment), nor clinical factors (number of relapses in the last year, basal EDSS and previous failure of IFN-b) significantly associated with the likelihood of attacks or disability progression.…”

Section: Discussionmentioning

confidence: 93%

Clinical Data Associated With the Therapeutic Response to Glatiramer Acetate in Multiple Sclerosis Patients

Peño¹,

Seco²,

Valencia³

et al. 2016

Neuro Open J

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The increasing appearance of new drugs is making more difficult the choice of treatment in multiple sclerosis. According to different criteria, between 20 to 50% of the patients with multiple sclerosis (MS) treated with the classical disease modify treatments (DMT) will have an incomplete response and will need a change for more aggressive therapies. For this reason it is of great importance to improve the selection process in these patients to avoid treatment failures, side-effects and unnecessary risks. The utility of clinical and epidemiological data for the prediction of the therapeutic response to the different MS treatments, and particularly to glatiramer acetate (GA), is insufficient and contradictory. Objective: To develop a predictive model of clinical data associated with the clinical response to GA. Methods: Observational retrospective study by reviewing medical charts from October/2002 to February/2012. Data analysis was conducted from February/2014 to February/2015. Inclusion criteria: Relapsing-remitting multiple sclerosis (RRMS McDonald 2010) with ≥1 relapses in the previous 2 years, and ≥2 years of treatment with GA. All the patients included in this study were treated with GA 20 mg injected subcutaneously once daily as the newer formulation of GA 40 mg 3 times weekly was not approved at the time of the study. Definitions: Responders: ≤1 relapse and no disability progression; Non-responders: ≥2 relapses and/or disability progression. Disability progression: EDSS increase ≥1.5 points if basal EDSS=0; increase ≥1 if basal EDSS=1-5; increase ≥0.5 if basal EDSS ≥5.5. Statistical analysis: logistic regression. Association variable: odds ratio. Results: Two hundred and four subjects included. Responders: 137 (67.5%). Number of relapses in the 2 years before GA onset was associated with a worse clinical response (odds ratio (OR): 1.4; IC 95%: 1.12-1.74%). Accuracy of this model (AUC: 63.5%; IC 95%: 56.2-70.7%); Diagnostic parameters: Sensitivity: 40%; specificity: 79.8%, positive predictive value: 78.6; negative predictive value: 41.7. Conclusions: GA was associated with a better response in Relapsing-remitting multiple sclerosis (RRMS) patients with low-moderate disease activity. This model could be improved incorporating serological, genetic and imaging data.

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Clinical and MRI predictors of response to interferon‐beta and glatiramer acetate in relapsing–remitting multiple sclerosis patients

Abstract: A lower baseline MRI and clinical activity have been identified as predictors of DMT efficacy in patients with RRMS in routine clinical practice. Evaluation of clinical and MRI activity at 1 year is recommended to monitor patients over time.

Cited by 29 publications

References 22 publications

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—establishing disease prognosis and monitoring patients

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—establishing disease prognosis and monitoring patients

Comparative efficacy of first-line natalizumab vs IFN-β or glatiramer acetate in relapsing MS

Clinical Data Associated With the Therapeutic Response to Glatiramer Acetate in Multiple Sclerosis Patients

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