Abstract: 96
Type: Oral
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Background: From the introduction of the “revised McDonald 2010” criteria, new evidences regarding the application of MRI for the diagnosis of multiple sclerosis (MS) have become available. According to evidence-based data, a modification of MRI diagnostic criteria has been proposed in 2016 by the MAGNIMS network (“MAGNIMS 2016” criteria).
Aims: To compare the performance of “revised McDonald 2010” and “MAGNIMS 2016” criteria for the development of MS in a large multicentric cohort of clinically isolated syndrome (CIS) patients.
Methods: Brain and spinal cord MRI sequences and assessment of optic nerve involvement (performed by clinical, MRI or neurophysiological assessment) were obtained from 309 CIS patients from eight centers within three and 12 months from disease onset. Patients were followed for at least 36 months or until MS clinical conversion (median follow-up=62.7 months). MRI criteria performances for dissemination in space (DIS) and time (DIT) were evaluated and hazard ratios (HR) to develop MS were estimated using extended Cox regression models.
Results: At follow-up, 210/309 (68.0%) CIS converted to MS. Both DIS criteria showed high sensitivity (“revised McDonald 2010”=0.91; “MAGNIMS 2016”=0.93), a similar specificity (“revised McDonald 2010”=0.33; “MAGNIMS 2016”=0.32) and accuracy (“revised McDonald 2010”=0.66; “MAGNIMS 2016”=0.67). For both sets of criteria, fulfillment of DIS was significantly associated to MS conversion (HR=3.44, p< 0.0001 for “revised McDonald 2010”; HR=4.58, p< 0.0001 for “MAGNIMS 2016”). DIS plus DIT performances from both criteria were also similar and their fulfillment was significantly associated with MS conversion (HR=2.48, p< 0.0001 for “revised McDonald 2010”; HR=2.91, p< 0.0001 for “MAGNIMS 2016”).
Conclusions: “MAGNIMS 2016” criteria showed a similar overall diagnostic accuracy compared to “revised McDonald 2010” criteria.
Disclosure:
M. Filippi is Editor-in-Chief of the Journal of Neurology; serves on a scientific advisory board for Teva Pharmaceutical Industries; has received compensation for consulting services and/or speaking activities from Biogen Idec, Merk-Serono, Novartis, and Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Teva Pharmaceutical Industries, Novartis, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla (FISM), Cure PSP, Alzheimer's Drug Discovery Foundation (ADDF), the Jacques and Gloria Gossweiler Foundation (Switzerland), and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
P. Preziosa received speakers honoraria from Biogen Idec, Novartis and ExceMED.
A. Meani, S. Mesaros, C. Enzinger, C. Gasperini, W. Brownlee, J. Drulovic, S. Cramer, A. Pichler, M. Hagens, S. Ruggieri, and K. Miszkiel, have nothing to disclose.
O. Ciccarelli is a consultant for Novartis, Biogen Idec, Genzyme, and General Electric, and all the payments are made to the UCL Institute of Neurology.
A. Rovira serves on scientific advisory boards for Biogen Idec, Novartis, Sanofi-Genzyme, and OLEA Medical,has received speaker honoraria from ExceMED Bayer, Genzyme, Sanofi-Aventis, Bracco, Merck-Serono, Teva Pharmaceutical Industries Ltd, OLEA Medical, Stendhal, Novartis and Biogen Idec, and has research agreements with Siemens AG and Icometrix.
J. Frederiksen reports personal fees from Almirall, Biogen, Genzyme, Merck Serono, Novartis, Sanofi-Aventis, and Teva for participation in scientific boards; speaker honoraria from Biogen, Merck Serono, and Teva; and personal fees for advising on preclinical development from Takeda outside of the submitted work.
F. Barkhof serves as a consultant for Bayer Schering Pharma, Sanofi-Aventis, Genzyme, Biogen-Idec, Teva, Novartis, Roche, Synthon BV and Jansen Research.
X. Montalban has received speaking honoraria and travel expenses for scientific meetings, has been a steering committee member of clinical trials or participated in advisory boards of clinical trials in the past with Almirall, Bayer, Biogen, Genzyme, Merck, Novartis, Receptos, Roche, Sanofi-Genzyme and Teva Pharmaceutical.
M.Tintorè has received compensation for consulting services and speaking honoraria from Bayer Schering Pharma, Merck-Serono, Biogen Idec, Teva Pharmaceuticals, Sanofi-Aventis, Novartis, Almirall, Genzyme and Roche.
G. Comi has received compensation for consulting services for Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, Roche, Almirall, Chugai, Receptos, and Forward Pharma, and compensation for speaking activities for Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, and Roche.
M.A. Rocca received speakers honoraria from Biogen Idec, Novartis, Teva Neurosciences and Genzyme and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
Abstract: 96
Type: Oral
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Background: From the introduction of the “revised McDonald 2010” criteria, new evidences regarding the application of MRI for the diagnosis of multiple sclerosis (MS) have become available. According to evidence-based data, a modification of MRI diagnostic criteria has been proposed in 2016 by the MAGNIMS network (“MAGNIMS 2016” criteria).
Aims: To compare the performance of “revised McDonald 2010” and “MAGNIMS 2016” criteria for the development of MS in a large multicentric cohort of clinically isolated syndrome (CIS) patients.
Methods: Brain and spinal cord MRI sequences and assessment of optic nerve involvement (performed by clinical, MRI or neurophysiological assessment) were obtained from 309 CIS patients from eight centers within three and 12 months from disease onset. Patients were followed for at least 36 months or until MS clinical conversion (median follow-up=62.7 months). MRI criteria performances for dissemination in space (DIS) and time (DIT) were evaluated and hazard ratios (HR) to develop MS were estimated using extended Cox regression models.
Results: At follow-up, 210/309 (68.0%) CIS converted to MS. Both DIS criteria showed high sensitivity (“revised McDonald 2010”=0.91; “MAGNIMS 2016”=0.93), a similar specificity (“revised McDonald 2010”=0.33; “MAGNIMS 2016”=0.32) and accuracy (“revised McDonald 2010”=0.66; “MAGNIMS 2016”=0.67). For both sets of criteria, fulfillment of DIS was significantly associated to MS conversion (HR=3.44, p< 0.0001 for “revised McDonald 2010”; HR=4.58, p< 0.0001 for “MAGNIMS 2016”). DIS plus DIT performances from both criteria were also similar and their fulfillment was significantly associated with MS conversion (HR=2.48, p< 0.0001 for “revised McDonald 2010”; HR=2.91, p< 0.0001 for “MAGNIMS 2016”).
Conclusions: “MAGNIMS 2016” criteria showed a similar overall diagnostic accuracy compared to “revised McDonald 2010” criteria.
Disclosure:
M. Filippi is Editor-in-Chief of the Journal of Neurology; serves on a scientific advisory board for Teva Pharmaceutical Industries; has received compensation for consulting services and/or speaking activities from Biogen Idec, Merk-Serono, Novartis, and Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Teva Pharmaceutical Industries, Novartis, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla (FISM), Cure PSP, Alzheimer's Drug Discovery Foundation (ADDF), the Jacques and Gloria Gossweiler Foundation (Switzerland), and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
P. Preziosa received speakers honoraria from Biogen Idec, Novartis and ExceMED.
A. Meani, S. Mesaros, C. Enzinger, C. Gasperini, W. Brownlee, J. Drulovic, S. Cramer, A. Pichler, M. Hagens, S. Ruggieri, and K. Miszkiel, have nothing to disclose.
O. Ciccarelli is a consultant for Novartis, Biogen Idec, Genzyme, and General Electric, and all the payments are made to the UCL Institute of Neurology.
A. Rovira serves on scientific advisory boards for Biogen Idec, Novartis, Sanofi-Genzyme, and OLEA Medical,has received speaker honoraria from ExceMED Bayer, Genzyme, Sanofi-Aventis, Bracco, Merck-Serono, Teva Pharmaceutical Industries Ltd, OLEA Medical, Stendhal, Novartis and Biogen Idec, and has research agreements with Siemens AG and Icometrix.
J. Frederiksen reports personal fees from Almirall, Biogen, Genzyme, Merck Serono, Novartis, Sanofi-Aventis, and Teva for participation in scientific boards; speaker honoraria from Biogen, Merck Serono, and Teva; and personal fees for advising on preclinical development from Takeda outside of the submitted work.
F. Barkhof serves as a consultant for Bayer Schering Pharma, Sanofi-Aventis, Genzyme, Biogen-Idec, Teva, Novartis, Roche, Synthon BV and Jansen Research.
X. Montalban has received speaking honoraria and travel expenses for scientific meetings, has been a steering committee member of clinical trials or participated in advisory boards of clinical trials in the past with Almirall, Bayer, Biogen, Genzyme, Merck, Novartis, Receptos, Roche, Sanofi-Genzyme and Teva Pharmaceutical.
M.Tintorè has received compensation for consulting services and speaking honoraria from Bayer Schering Pharma, Merck-Serono, Biogen Idec, Teva Pharmaceuticals, Sanofi-Aventis, Novartis, Almirall, Genzyme and Roche.
G. Comi has received compensation for consulting services for Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, Roche, Almirall, Chugai, Receptos, and Forward Pharma, and compensation for speaking activities for Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, and Roche.
M.A. Rocca received speakers honoraria from Biogen Idec, Novartis, Teva Neurosciences and Genzyme and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.