HLA-DRB1⁎15 and cerebrospinal-fluid-specific oligoclonal immunoglobulin G bands lower age at attainment of important disease milestones in multiple sclerosis

Cerebrospinal fluid oligoclonal bands in multiple sclerosis and clinically isolated syndromes: a meta-analysis of prevalence, prognosis and effect of latitude

“…In all of the studies using IEF with immunofixation, Expanded Disability Status Scale (EDSS)-related outcome measures were used to define clinical outcomes; one used EDSS of 4 at 10 years disease duration,15 two used EDSS 6 during follow-up16 17 and one used an increase of ≥1 EDSS point in 5 years 18. When the results were combined, 667 of 1764 (37.8%) OCB-positive patients reached the disability outcome measures specified in the study compared with 42 of 154 (27.2%) OCB-negative patients (p<0.0001, Fisher's exact test).…”

New perspectives in the natural history of multiple sclerosis

“…39 Further, patients negative for both HLA-DRB1*15 and oligoclonal banding were 10 years younger when reaching EDSS 6 compared to those positive for both. 40 Most imaging, biologic, or surrogate markers tend to be collected as part of cross-sectional or short-term cohort studies, comprehensive reviews of which can be found elsewhere. Special mention is given to a small but valuable cohort of patients with clinically isolated syndrome (i.e., a single neurologic attack compatible with MS); 107/140 (75%) were followed for a mean of 20 years; 67/107 (63%) fulfilled diagnostic criteria for MS, and T2 lesion volume changes and gray matter atrophy (but not white matter atrophy), particularly in the first 5 years, were associated with increased disability at 20 years and development of secondary-progressive MS. 41 Relapses and disease progression: An apparent dissociation.…”

Does cerebrospinal fluid analysis add predictive value to magnetic resonance imaging for long term irreversible disability in patients with early multiple sclerosis?

“…A recent metaanalysis concluded that the presence of OB was predictive of reaching disability outcomes earlier [11]. An odds-ratio of 1.96 was reported based on 4 studies using isoelectrofocusing [16][17][18][19] including one study concerning IgM OB, which is a different issue [15,20]. The results were mainly driven by a study performed retrospectively in 1488 Swedish registry patients and used unadjusted Cox-models to predict the age at attainment of an EDSS of 6.0 [19].…”