Contributions
Abstract: P546
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Objective: Clinical features of multiple sclerosis (MS) in Asians have been reported to be different from those in Caucasians. To identify differences in brain MRI features between Japanese and Caucasian MS patients by analysing and comparing baseline data from phase II fingolimod (FTY) trials with comparable inclusion criteria in both populations.
Methods: Data from ninety-five Japanese and 84 Caucasian patients with MS with Expanded Disability Status Scale (EDSS) score of 0 to 6 were included in this analysis. T2-weighted (T2w) cerebral MRI at study baseline was used to evaluate the number, volume, and distribution of MS lesions. Using SIENAx (FSL), normalized total brain (NBV), cortical gray matter (cGM), white matter (WM) and deep gray matter (dGM) volumes were also assessed in the70-mm central area of the brain (z-block: MNI152 z-coordinates -10, bottom, to +60 mm, top).
Results: Japanese patients had a lower frequency of secondary progressive MS (2.1 % vs. 14.3 %, p = 0.004), lower EDSS score (mean 2.0 vs. 2.6, p = 0.009) and Multiple Sclerosis Severity Score (mean 3.26 vs. 4.09, p = 0.008) and higher frequency of disease modifying therapy (DMT) for MS (57.9 % vs. 34.5 %, p = 0.002) compared with Caucasian patients. After adjusting for sex, age, MS subtype, disease duration, and previous DMT exposure, Japanese patients had marginally fewer number of T2w-lesions (mean 62 vs. 79, p = 0.06) and significantly lower NBV (mean 942,018 mm³ vs. 969,824 mm³, p< 0.001) compared with Caucasian patients. In univariate analysis, Japanese patients had lower frequency of T2 lesions in cerebellum than Caucasian patients (44.9 % vs. 68.7 %, p= 0.006). Cortical gray matter volume (cGMV)/NBV ratio was significantly lower in Caucasian patients than Japanese patients (p= 0.0003). NBV and deep grey matter volume (dGMV) had a significant inverse correlation with EDSS in both Japanese and Caucasian patients (NBV: r = -0.32, p = 0.004; r = -0.64, p < 0.0001. dGMV: r = -0.48, p < 0.0001; r = -0.34, p = 0.008, Spearman rank coefficient).
Conclusions: Japanese patients had numerically fewer T2w lesions and less cerebellar involvement compared with matched Caucasian patients, which may be related to milder disease severity and progression.
Disclosure: Yuri Nakamura: nothing to disclose
Laura Gaetano: nothing to disclose
Takuya Matsushita: He has received honoraria from Bayer Schering Pharma, Biogen Idec, Takeda Pharmaceutical Company and Mitsubishi Tanabe Pharma.
Anna Altermatt: nothing to disclose
Till Sprenger: author"s previous and current institutions have received payments for consulting and speaking activities (Actelion, Biogen Idec, Electrocore, Genzyme, Mitsubishi Pharma, Novartis); grants received (EFIC-Grünenthal, Novartis Pharmaceuticals Switzerland, Swiss MS Society, Swiss National Research Foundation).
Ernst-Wilhelm Radue: nothing to disclose
Lorena Bauer: nothing to disclose
Michael Amann: nothing to disclose
Jens Würfel: he is CEO of MIAC AG, Basel, Switzerland. He served for advisory boards of Biogen, Novartis, Genzyme, TEVA.
Takahiko Saida: nothing to disclose
Ludwig Kappos: Institution (University Hospital Basel) received in the last 3 years and used exclusively for research support: steering committee for and consulting fees from Actelion, Addex, Bayer HealthCare, Biogen, Biotica, Genzyme, Lilly, Merck, Mitsubishi, Novartis, Ono, Pfizer, Receptos, Sanofi-Aventis, Santhera, Siemens, Teva, UCB and Xenoport; speaker fees: Bayer HealthCare, Biogen, Merck, Novartis, Sanofi-Aventis and Teva; support of educational activities from Bayer HealthCare, Biogen, CSL Behring, Genzyme, Merck, Novartis, Sanofi-Aventis and Teva; royalties from Neurostatus Systems GmbH; grants from Bayer HealthCare, Biogen, the European Union, Merck, Novartis, Roche, Roche Research Foundations, the Swiss Multiple Sclerosis Society and the Swiss National Research Foundation.
Jun-ichi Kira: He is a consultant for Biogen Idec Japan and Medical Review. He has received honoraria from Bayer Healthcare, Mitsubishi Tanabe Pharma, Nobelpharma, Otsuka Pharmaceutical and Medical Review. He is funded by a research grant for Nervous and Mental Disorders from the Ministry of Health, Labour and Welfare, Japan and grants from the Japan Science and Technology Agency and the Ministry of Education, Culture, Sports, Science and Technology, Japan.
This independent academic research was supported by Novartis and Mitsubishi Tanabe Pharma Corporation who provided baseline demographic data for the patients analyzed. Novartis and Mitsubishi Tanabe Pharma Corporation played no role in the design, methods, data management or analysis of the study.
Abstract: P546
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Objective: Clinical features of multiple sclerosis (MS) in Asians have been reported to be different from those in Caucasians. To identify differences in brain MRI features between Japanese and Caucasian MS patients by analysing and comparing baseline data from phase II fingolimod (FTY) trials with comparable inclusion criteria in both populations.
Methods: Data from ninety-five Japanese and 84 Caucasian patients with MS with Expanded Disability Status Scale (EDSS) score of 0 to 6 were included in this analysis. T2-weighted (T2w) cerebral MRI at study baseline was used to evaluate the number, volume, and distribution of MS lesions. Using SIENAx (FSL), normalized total brain (NBV), cortical gray matter (cGM), white matter (WM) and deep gray matter (dGM) volumes were also assessed in the70-mm central area of the brain (z-block: MNI152 z-coordinates -10, bottom, to +60 mm, top).
Results: Japanese patients had a lower frequency of secondary progressive MS (2.1 % vs. 14.3 %, p = 0.004), lower EDSS score (mean 2.0 vs. 2.6, p = 0.009) and Multiple Sclerosis Severity Score (mean 3.26 vs. 4.09, p = 0.008) and higher frequency of disease modifying therapy (DMT) for MS (57.9 % vs. 34.5 %, p = 0.002) compared with Caucasian patients. After adjusting for sex, age, MS subtype, disease duration, and previous DMT exposure, Japanese patients had marginally fewer number of T2w-lesions (mean 62 vs. 79, p = 0.06) and significantly lower NBV (mean 942,018 mm³ vs. 969,824 mm³, p< 0.001) compared with Caucasian patients. In univariate analysis, Japanese patients had lower frequency of T2 lesions in cerebellum than Caucasian patients (44.9 % vs. 68.7 %, p= 0.006). Cortical gray matter volume (cGMV)/NBV ratio was significantly lower in Caucasian patients than Japanese patients (p= 0.0003). NBV and deep grey matter volume (dGMV) had a significant inverse correlation with EDSS in both Japanese and Caucasian patients (NBV: r = -0.32, p = 0.004; r = -0.64, p < 0.0001. dGMV: r = -0.48, p < 0.0001; r = -0.34, p = 0.008, Spearman rank coefficient).
Conclusions: Japanese patients had numerically fewer T2w lesions and less cerebellar involvement compared with matched Caucasian patients, which may be related to milder disease severity and progression.
Disclosure: Yuri Nakamura: nothing to disclose
Laura Gaetano: nothing to disclose
Takuya Matsushita: He has received honoraria from Bayer Schering Pharma, Biogen Idec, Takeda Pharmaceutical Company and Mitsubishi Tanabe Pharma.
Anna Altermatt: nothing to disclose
Till Sprenger: author"s previous and current institutions have received payments for consulting and speaking activities (Actelion, Biogen Idec, Electrocore, Genzyme, Mitsubishi Pharma, Novartis); grants received (EFIC-Grünenthal, Novartis Pharmaceuticals Switzerland, Swiss MS Society, Swiss National Research Foundation).
Ernst-Wilhelm Radue: nothing to disclose
Lorena Bauer: nothing to disclose
Michael Amann: nothing to disclose
Jens Würfel: he is CEO of MIAC AG, Basel, Switzerland. He served for advisory boards of Biogen, Novartis, Genzyme, TEVA.
Takahiko Saida: nothing to disclose
Ludwig Kappos: Institution (University Hospital Basel) received in the last 3 years and used exclusively for research support: steering committee for and consulting fees from Actelion, Addex, Bayer HealthCare, Biogen, Biotica, Genzyme, Lilly, Merck, Mitsubishi, Novartis, Ono, Pfizer, Receptos, Sanofi-Aventis, Santhera, Siemens, Teva, UCB and Xenoport; speaker fees: Bayer HealthCare, Biogen, Merck, Novartis, Sanofi-Aventis and Teva; support of educational activities from Bayer HealthCare, Biogen, CSL Behring, Genzyme, Merck, Novartis, Sanofi-Aventis and Teva; royalties from Neurostatus Systems GmbH; grants from Bayer HealthCare, Biogen, the European Union, Merck, Novartis, Roche, Roche Research Foundations, the Swiss Multiple Sclerosis Society and the Swiss National Research Foundation.
Jun-ichi Kira: He is a consultant for Biogen Idec Japan and Medical Review. He has received honoraria from Bayer Healthcare, Mitsubishi Tanabe Pharma, Nobelpharma, Otsuka Pharmaceutical and Medical Review. He is funded by a research grant for Nervous and Mental Disorders from the Ministry of Health, Labour and Welfare, Japan and grants from the Japan Science and Technology Agency and the Ministry of Education, Culture, Sports, Science and Technology, Japan.
This independent academic research was supported by Novartis and Mitsubishi Tanabe Pharma Corporation who provided baseline demographic data for the patients analyzed. Novartis and Mitsubishi Tanabe Pharma Corporation played no role in the design, methods, data management or analysis of the study.