Contributions
Abstract: EP1277
Type: ePoster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Background: The early identification of patients with isolated spinal syndromes at high risk of multiple sclerosis (MS) represents the main purpose of the evolving diagnostic criteria and of clinicians in everyday clinical practice. The aim of this study was to investigate the prognostic role of different biomarkers in patients with an isolated spinal syndrome.
Methods: We evaluated baseline clinical, MRI, CSF and neurophysiological data of 218 patients (mean age 32.9 years) with a first spinal inflammatory episode. We used discrimination and calibration characteristics and reclassification of risk categories to assess incremental utility of different biomarkers for MS prediction.
Results: During follow-up (median 7.3 years), 112 of the 218 participants developed clinically definte MS (CDMS). In Cox proportional-hazards models adjusted for age at onset and gender, the number of brain T2 lesions (>9 lesions vs < 2 lesions, HR 6.5 95% CIs 1.4 -15.7), the presence of CSF OCBs (HR 2.3 95% CIs 1.0-4.0) and the multimodal evoked potential score (4th quartile vs 1 quartile, HR 2.5 CIs 1.2-4.2) significantly predicted the subsequent development of CDMS. The same biomarkers were significantly associated also with the development of MS according to 2010 diagnostic criteria in the follow-up. The use of multiple biomarkers led to a 27% net-reclassification improvement (p < 0.001) over the use of current MRI criteria for MS in the prediction of patients with spinal isolated syndromes who develop multiple sclerosis at 2 years.
Conclusions: The simultaneous addition of several biomarkers improves the risk stratification for MS in patients with isolated spinal syndromes beyond that of a model based only on MRI criteria.
Disclosure: G.D.C., G.D.M., F.S., B.C. report no disclosures V.M. has received honoraria for activities with Biogen, Merck Serono, Bayer Schering, TEVA, and Sanofi Aventis as a speaker. L. M. has received honoraria for speaking in scientific meetings and for advisory board from Biogen TEVA, Sanofi- Genzyme, and Merck. R.F. has received honoraria for speaker activities from Biogen, Merck, Novartis, Roche, and Teva. L.L.has received honoraria for consulting services and/or speaking activity from Biogen Idec,, Novartis, Excemed. G.C. has received personal compensation for consulting services and/or speaking activities from Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, Serono Symposia International Foundation, Roche, Almirall, Receptos, Celgene, Forward Pharma.
Abstract: EP1277
Type: ePoster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Background: The early identification of patients with isolated spinal syndromes at high risk of multiple sclerosis (MS) represents the main purpose of the evolving diagnostic criteria and of clinicians in everyday clinical practice. The aim of this study was to investigate the prognostic role of different biomarkers in patients with an isolated spinal syndrome.
Methods: We evaluated baseline clinical, MRI, CSF and neurophysiological data of 218 patients (mean age 32.9 years) with a first spinal inflammatory episode. We used discrimination and calibration characteristics and reclassification of risk categories to assess incremental utility of different biomarkers for MS prediction.
Results: During follow-up (median 7.3 years), 112 of the 218 participants developed clinically definte MS (CDMS). In Cox proportional-hazards models adjusted for age at onset and gender, the number of brain T2 lesions (>9 lesions vs < 2 lesions, HR 6.5 95% CIs 1.4 -15.7), the presence of CSF OCBs (HR 2.3 95% CIs 1.0-4.0) and the multimodal evoked potential score (4th quartile vs 1 quartile, HR 2.5 CIs 1.2-4.2) significantly predicted the subsequent development of CDMS. The same biomarkers were significantly associated also with the development of MS according to 2010 diagnostic criteria in the follow-up. The use of multiple biomarkers led to a 27% net-reclassification improvement (p < 0.001) over the use of current MRI criteria for MS in the prediction of patients with spinal isolated syndromes who develop multiple sclerosis at 2 years.
Conclusions: The simultaneous addition of several biomarkers improves the risk stratification for MS in patients with isolated spinal syndromes beyond that of a model based only on MRI criteria.
Disclosure: G.D.C., G.D.M., F.S., B.C. report no disclosures V.M. has received honoraria for activities with Biogen, Merck Serono, Bayer Schering, TEVA, and Sanofi Aventis as a speaker. L. M. has received honoraria for speaking in scientific meetings and for advisory board from Biogen TEVA, Sanofi- Genzyme, and Merck. R.F. has received honoraria for speaker activities from Biogen, Merck, Novartis, Roche, and Teva. L.L.has received honoraria for consulting services and/or speaking activity from Biogen Idec,, Novartis, Excemed. G.C. has received personal compensation for consulting services and/or speaking activities from Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, Serono Symposia International Foundation, Roche, Almirall, Receptos, Celgene, Forward Pharma.