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Measures in the first year of therapy predict the response to interferon β in MS
J Río1, J Castilló1, A Rovira2, M Tintoré1, J Sastre-Garriga1, A Horga1, C Nos1, M Comabella1, X Aymerich2 and X Montalbán1 Background and objective Several criteria for treatment response to interferon beta (IFNβ) have been proposed, although there is no consensus among different investigators. Hence, the aim of this study was to investigate magnetic resonance imaging (MRI) and clinical predictors of response during the first 12 months of therapy.

Methods: This is a prospective and longitudinal study of relapsing-remitting multiple sclerosis (RRMS) patients treated with IFNβ. Patients were classified based on the presence of new lesions on MRI, relapses, confirmed disability increase, or combinations of all these variables after 1 year of therapy. Regression analysis was performed in order to identify variables of response after a follow-up of 3 years.

Results: We included 222 RRMS patients. The logistic model demonstrated that only the combination of new active lesions on MRI with the presence of relapses (OR 4.4; 95% CI 1.6–12.5) or disability progression (Odds Ratio (OR) 7.1; 95% Confidence Interval (CI) 1.6–33.9), or both (OR 6.5; 95% CI 1.9–23.4) achieved significant values to identify those patients with a poor outcome.

Conclusions: In RRMS patients treated with IFNβ, the combination of measures of disease activity and the presence of new active lesions on MRI may have a prognostic value for identifying patients with disease activity in the second and third year of therapy.

Reference: Rio J, Castillo J, Rovira A, Tintore M, Sastre-Garriga J, Horga A, et al. Measures in the first year of therapy predict the response to interferon beta in MS. Mult Scler 2009; 15: 848–853. doi: 10.1177/1352458509104591

Calculator reference: Sormani MP, De Stefano N. Nat Rev Neurol 2013;9:504-12

*Active lesions:Defined as new or enlarging T2-weighted lesions plus gadolinium-enhancing lesions over the first year.

*Abbreviation: EDSS, Expanded Disability Status Scale.
Patients who were positive for at least two of the three criteria analyzed after the first year of IFN-β therapy were found to have a higher probability of experiencing disability progression or showing relapse activity at follow-up.
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