Abstract: EP1475
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - Biomarkers
Abstract: The presence of cerebrospinal fluid (CSF) oligoclonal bands (OCB) in patients with multiple sclerosis (MS) has been claimed to be associated with disease severity. In the present study, we investigated the clinical and MRI features of Korean MS patients according to the OCB status.
Methods: We enrolled 90 MS patients who were tested for both serum and CSF OCB using isoelectric focusing with immunofixation from two referral centers. All patients were seronegative for aquaporin-4 antibodies. We compared clinical profiles, CSF findings and individual MRI parameters of the 2005 and 2010 McDonald DIS criteria at the onset of the first symptoms between patients with and without OCB.
Results: Of 90 patients, 41 patients (45.6%) were positive for CSF-restricted OCB. Patients with OCB (OCB+) were found to have younger onset of disease (P=0.005), higher frequency of CSF pleocytosis (P=0.009) and higher frequency of IgG index over 0.7 (P=0.015) than patients without OCB (OCB-). There was a trend towards higher initial Expanded Disability Status Scale (EDSS) score in OCB+ than OCB- (1.5 vs 1.0); however, the difference did not reach statistical significance (P=0.146). Cerebral symptoms were more commonly observed as a presenting symptom in OCB+, whereas partial myelitis was more commonly found in OCB-. The average number of T2 or FLAIR hyperintense lesions and gadolinium-enhancing lesions were higher in OCB+ than OCB-. The 2005 criterion specifying the presence of ≥9 T2 lesions (P=0.003), ≥3 periventricular (PV) lesions (P=0.005) and the 2010 criterion noting the presence of PV lesion (P< 0.001) and asymptomatic spinal cord lesions (P=0.049) were more frequently met in OCB+ than OCB-. The interval from onset to initiation of disease modifying therapy (DMT) was shorter in OCB+ than OCB- (17.6±27.2 vs. 34.9±48.0, months, P=0.044); however, the time to the first relapse (23.7±30.1 vs. 18.8±35.5, months, P=0.552), the rate of failure of first-line DMT (31.7% vs 22.9%, P=0.473), the median EDSS at last follow-up (2.0 vs. 1.5, P=0.642; average follow-up duration of 68 months) were not significantly different between two groups.
Conclusion: OCB+ patients had younger onset of disease and higher MRI lesion load than OCB- patients. However, the presence of OCB was not associated with the DMT response or disability score for an average follow-up of 68 months. Longer term follow-up and further investigation is needed to determine the significance of these findings.
Disclosure: So-Young Huh: nothing to disclose, Su-Hyun Kim: nothing to disclose, Jae-Won Hyun: nothing to disclose, In Hye Jeong: nothing to disclose, Min Su Park: nothing to disclose, Woo jun Kim: nothing to disclose,
HJ Kim has received honoraria for speaking or consulting for Bayer Schering Pharma, Biogen Idec, Genzyme, Merck Serono, Novartis, MedImmune, and Teva-Handok and has received research grants from Genzyme, Merck Serono, and Kael-GemVax. He serves on a steering committee for MedImmune and serves as an editor for the Multiple Sclerosis Journal - Experimental, Translational and Clinical.
Abstract: EP1475
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - Biomarkers
Abstract: The presence of cerebrospinal fluid (CSF) oligoclonal bands (OCB) in patients with multiple sclerosis (MS) has been claimed to be associated with disease severity. In the present study, we investigated the clinical and MRI features of Korean MS patients according to the OCB status.
Methods: We enrolled 90 MS patients who were tested for both serum and CSF OCB using isoelectric focusing with immunofixation from two referral centers. All patients were seronegative for aquaporin-4 antibodies. We compared clinical profiles, CSF findings and individual MRI parameters of the 2005 and 2010 McDonald DIS criteria at the onset of the first symptoms between patients with and without OCB.
Results: Of 90 patients, 41 patients (45.6%) were positive for CSF-restricted OCB. Patients with OCB (OCB+) were found to have younger onset of disease (P=0.005), higher frequency of CSF pleocytosis (P=0.009) and higher frequency of IgG index over 0.7 (P=0.015) than patients without OCB (OCB-). There was a trend towards higher initial Expanded Disability Status Scale (EDSS) score in OCB+ than OCB- (1.5 vs 1.0); however, the difference did not reach statistical significance (P=0.146). Cerebral symptoms were more commonly observed as a presenting symptom in OCB+, whereas partial myelitis was more commonly found in OCB-. The average number of T2 or FLAIR hyperintense lesions and gadolinium-enhancing lesions were higher in OCB+ than OCB-. The 2005 criterion specifying the presence of ≥9 T2 lesions (P=0.003), ≥3 periventricular (PV) lesions (P=0.005) and the 2010 criterion noting the presence of PV lesion (P< 0.001) and asymptomatic spinal cord lesions (P=0.049) were more frequently met in OCB+ than OCB-. The interval from onset to initiation of disease modifying therapy (DMT) was shorter in OCB+ than OCB- (17.6±27.2 vs. 34.9±48.0, months, P=0.044); however, the time to the first relapse (23.7±30.1 vs. 18.8±35.5, months, P=0.552), the rate of failure of first-line DMT (31.7% vs 22.9%, P=0.473), the median EDSS at last follow-up (2.0 vs. 1.5, P=0.642; average follow-up duration of 68 months) were not significantly different between two groups.
Conclusion: OCB+ patients had younger onset of disease and higher MRI lesion load than OCB- patients. However, the presence of OCB was not associated with the DMT response or disability score for an average follow-up of 68 months. Longer term follow-up and further investigation is needed to determine the significance of these findings.
Disclosure: So-Young Huh: nothing to disclose, Su-Hyun Kim: nothing to disclose, Jae-Won Hyun: nothing to disclose, In Hye Jeong: nothing to disclose, Min Su Park: nothing to disclose, Woo jun Kim: nothing to disclose,
HJ Kim has received honoraria for speaking or consulting for Bayer Schering Pharma, Biogen Idec, Genzyme, Merck Serono, Novartis, MedImmune, and Teva-Handok and has received research grants from Genzyme, Merck Serono, and Kael-GemVax. He serves on a steering committee for MedImmune and serves as an editor for the Multiple Sclerosis Journal - Experimental, Translational and Clinical.