Reliability of Classifying Multiple Sclerosis Disease Activity Using Magnetic Resonance Imaging in a Multiple Sclerosis Clinic

Altay, Ebru Erbayat; Fisher, Elizabeth; Jones, Stephen E.; Hara-Cleaver, Claire; Lee, Jar-Chi; Rudick, Richard A.

doi:10.1001/2013.jamaneurol.211

Cited by 85 publications

(61 citation statements)

References 26 publications

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“…Based on this, we assess the value of GBCA administration as lower in the setting of disease monitoring as compared to the diagnostic MRI. However, it cannot be ruled out that GBCA administration may increase sensitivity for new disease activity even at routine follow‐up MRI,42, 43 especially considering the interobserver variability of identifying new or enlarged T2 lesions 22…”

Section: Resultsmentioning

confidence: 99%

Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society

et al. 2016

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Multiple sclerosis (MS) is associated with inflammatory lesions in the brain and spinal cord. The detection of such inflammatory lesions using magnetic resonance imaging (MRI) is important in the consideration of the diagnosis and differential diagnoses of MS, as well as in the monitoring of disease activity and predicting treatment efficacy. Although there is strong evidence supporting the use of MRI for both the diagnosis and monitoring of disease activity, there is a lack of evidence regarding which MRI protocols to use, the frequency of examinations, and in what clinical situations to consider MRI examination. A national workshop to discuss these issues was held in Stockholm, Sweden, in August 2015, which resulted in a Swedish consensus statement regarding the use of MRI in the care of individuals with MS. The aim of this consensus statement is to provide practical advice for the use of MRI in this setting. The recommendations are based on a review of relevant literature and the clinical experience of workshop attendees. It is our hope that these recommendations will benefit individuals with MS and guide healthcare professionals responsible for their care.

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Section: Resultsmentioning

confidence: 99%

Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society

et al. 2016

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“…2 Quantitative measures made from MRI scans of the brain and spinal cord are also used as secondary outcomes in clinical trials of new putative treatments for MS. Measures of inflammatory activity may be made from contrastenhanced T 1 -weighted images by assessing the number or volume of enhancing lesions.…”

Section: Introdutionmentioning

confidence: 99%

Estimating Brain Lesion Volume Change in Multiple Sclerosis by Subtraction of Magnetic Resonance Images

Horsfield¹,

Rocca

Pagani

et al. 2016

Journal of Neuroimaging

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“…The time required to confirm disability worsening was 6 months in our study versus 3 months in RCTs. Another difference is that we did not consider enlarged T2 lesions in the assessment of MRI activity, since a previous study demonstrated a poor between-rater agreement for this metric under routine clinical setting [32].…”

Section: Discussionmentioning

confidence: 99%

“…We decided to not consider enlarged T2-hyperintense lesions since a previous study demonstrated a poor between-rater agreement for this metric under routine clinical setting [32].…”

Section: Outcome Measuresmentioning

confidence: 99%

Baseline characteristics associated with NEDA-3 status in fingolimod-treated patients with relapsing-remitting multiple sclerosis

Giuliani

Logoteta

Prosperini

et al. 2017

Mult Scler Demyelinating Disord

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Background: Fingolimod is an efficacious treatment for relapsing-remitting multiple sclerosis (RRMS) and there is class I evidence that it is superior to standard care in reducing relapse rate. However, real-world data investigating its effectiveness and potential predictors of response are still scarce. Objective: To estimate (i) the proportion of fingolimod-treated patients who achieved the no evidence of disease activity (NEDA-3) status; and (ii) to determine which baseline (i.e. at treatment start) clinical and magnetic resonance imaging (MRI) variables were associated with better outcomes. Methods: We collected clinical and MRI data of RRMS patients treated with fingolimod and followed-up for 24 months. The proportion of patients who had NEDA-3 -i.e. absence of relapses, sustained Expanded Disability Status Scale (EDSS) worsening and radiological activity on MRI -was estimated. A Cox proportional hazard model was carried out to investigate which baseline characteristics were associated with the NEDA status at follow-up. Results: We collected data of 201 patients who started fingolimod. Of them, 24 (12%) were treatment-naïve, 115 (58%) were switched after failing a self-injectable drug, and 60 (30%) switching from natalizumab. Five patients who discontinued fingolimod early (within 3 months) (bradycardia, n = 2; leukopaenia, n = 2; macular oedema, n = 1) were removed from the analysis. At follow-up, 118 (60%) patients achieved the NEDA-3 status, while 78 experienced clinical and/or MRI activity. The risk of not achieving the NEDA-3 status was associated with higher baseline EDSS score (hazard ratio [HR] = 1.18, p = 0.024) and more relapses in the 12 months prior to fingolimod start (HR = 1.61, p = 0.014). Conclusion: Our findings suggest that fingolimod may lead to a better control of the disease if started in patients with a less aggressive disease (i.e. fewer pre-treatment relapses and milder disability level), thus supporting its possible role as an early treatment for MS.

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Reliability of Classifying Multiple Sclerosis Disease Activity Using Magnetic Resonance Imaging in a Multiple Sclerosis Clinic

Cited by 85 publications

References 26 publications

Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society

Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society

Estimating Brain Lesion Volume Change in Multiple Sclerosis by Subtraction of Magnetic Resonance Images

Baseline characteristics associated with NEDA-3 status in fingolimod-treated patients with relapsing-remitting multiple sclerosis

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