ECTRIMS eLearning

Early MS patients meeting NEDA show no significant gray matter decline
Author(s):
E. Morris
,
E. Morris
Affiliations:
G. Askin
,
G. Askin
Affiliations:
N. Nealon
,
N. Nealon
Affiliations:
T. Vartanian
,
T. Vartanian
Affiliations:
J. Perumal
,
J. Perumal
Affiliations:
U. Kauzner
,
U. Kauzner
Affiliations:
S. Gauthier
S. Gauthier
Affiliations:
ECTRIMS Learn. Morris E. 09/16/16; 146684; P844
Eric Morris
Eric Morris
Contributions
Abstract

Abstract: P844

Type: Poster

Abstract Category: Clinical aspects of MS - Natural course

Background: No evidence disease activity (NEDA) has been recently evaluated as a possible therapeutic target. MRI volumetric measurements have been considered as an addition to determine disease stability, however this may not be feasible in the clinical setting.

Objectives: The objective of this study was to investigate the rate of achieving NEDA within a population of early treatment naïve MS patients and explore how this definition relates to change in cortical thickness and thalamic volume.

Methods: Ninety seven patients within three years of first symptom (FS) and treatment naïve were enrolled in this prospective study and initiated disease modifying therapy. Annual EDSS, MRI and relapse data was collected for 36 months. NEDA at 36 months (NEDA36) was defined as no relapses, no change in EDSS, and no new contrast-enhancing or new T2 hyperintense lesions on Brain MRI. Global cortical thickness (GCT) and thalamic volume (TV) were measured using Freesurfer"s longitudinal pipeline.

Results: Baseline clinical and MRI characteristics included (mean, SD): age 36.4±9.1, EDSS 1.3±1.2, TV 15,434.3 mm3 ± 2009.1 and GCT 176.8± 177.2 . Sixty seven subjects completed annual clinical evaluations and demonstrated no change in EDSS relative to baseline (p=0.133). Of the 59 patients completing all MRI"s, there was no change in GCT (p=0.393), however there was a significant decline in TV (308.3 mm3 ± 721.9, p=0.0018). Only eighteen subjects (26.9%) met NEDA36 criteria for which none demonstrated significant change in GCT or TV.

Conclusions: Within a cohort of early MS patients TV revealed a significant decline within a period of 36 months. A relatively small percent of patients achieved NEDA, however those that did, revealed stable GCT and TV. Therefore, in early MS, MRI volumetric measurements may not be required to assume overall disease stability.

Disclosure: Eric Morris: nothing to disclose. Gulce Askin: nothing to disclose. Timothy Vartanian, MD, PhD is a speaker for Teva Neuroscience, has received honoraria for advising Genzyme, and has received grant support from the National Multiple Sclerosis Society, Biogen Idec, and Mallinckrodt pharmaceuticals. Nancy Nealon, MD: nothing to disclose. Jai Perumal, MD is a speaker for Biogen Idec, Teva Neuroscience, Genzyme, and Acorda and has consulted for Biogen Idec and Genzyme. Susan A. Gauthier DO, MPH has received honoraria for advising Genzyme and Teva Neuroscience and has received grant support from the National Multiple Sclerosis Society, Biogen Idec, Novartis Pharmaceuticals, Mallinckrodt pharmaceuticals, Genzyme, and EMD Serono.

Abstract: P844

Type: Poster

Abstract Category: Clinical aspects of MS - Natural course

Background: No evidence disease activity (NEDA) has been recently evaluated as a possible therapeutic target. MRI volumetric measurements have been considered as an addition to determine disease stability, however this may not be feasible in the clinical setting.

Objectives: The objective of this study was to investigate the rate of achieving NEDA within a population of early treatment naïve MS patients and explore how this definition relates to change in cortical thickness and thalamic volume.

Methods: Ninety seven patients within three years of first symptom (FS) and treatment naïve were enrolled in this prospective study and initiated disease modifying therapy. Annual EDSS, MRI and relapse data was collected for 36 months. NEDA at 36 months (NEDA36) was defined as no relapses, no change in EDSS, and no new contrast-enhancing or new T2 hyperintense lesions on Brain MRI. Global cortical thickness (GCT) and thalamic volume (TV) were measured using Freesurfer"s longitudinal pipeline.

Results: Baseline clinical and MRI characteristics included (mean, SD): age 36.4±9.1, EDSS 1.3±1.2, TV 15,434.3 mm3 ± 2009.1 and GCT 176.8± 177.2 . Sixty seven subjects completed annual clinical evaluations and demonstrated no change in EDSS relative to baseline (p=0.133). Of the 59 patients completing all MRI"s, there was no change in GCT (p=0.393), however there was a significant decline in TV (308.3 mm3 ± 721.9, p=0.0018). Only eighteen subjects (26.9%) met NEDA36 criteria for which none demonstrated significant change in GCT or TV.

Conclusions: Within a cohort of early MS patients TV revealed a significant decline within a period of 36 months. A relatively small percent of patients achieved NEDA, however those that did, revealed stable GCT and TV. Therefore, in early MS, MRI volumetric measurements may not be required to assume overall disease stability.

Disclosure: Eric Morris: nothing to disclose. Gulce Askin: nothing to disclose. Timothy Vartanian, MD, PhD is a speaker for Teva Neuroscience, has received honoraria for advising Genzyme, and has received grant support from the National Multiple Sclerosis Society, Biogen Idec, and Mallinckrodt pharmaceuticals. Nancy Nealon, MD: nothing to disclose. Jai Perumal, MD is a speaker for Biogen Idec, Teva Neuroscience, Genzyme, and Acorda and has consulted for Biogen Idec and Genzyme. Susan A. Gauthier DO, MPH has received honoraria for advising Genzyme and Teva Neuroscience and has received grant support from the National Multiple Sclerosis Society, Biogen Idec, Novartis Pharmaceuticals, Mallinckrodt pharmaceuticals, Genzyme, and EMD Serono.

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