Contributions
Abstract: EP1682
Type: Poster Sessions
Abstract Category: Therapy - Tools for detecting therapeutic response
Background: Quantitative measures of radiographic disease makers in multiple sclerosis (MS) are important in clinical trials and in clinical practice, where clinical MRI scans are difficult to standardize. DMF and FTY are oral disease-modifying agents (DMT) that are effective in reducing relapse rate in randomized placebo-controlled trials. Their comparative efficacies in quantitative radiographic outcomes are unknown.
Objective: To quantify and compare dimethyl fumarate (DMF) and fingolimod (FTY)'s effects on brain parenchymal fraction (BPF) and T2 lesion volume (T2LV) using clinical MRI scans of MS patients from a retrospective cohort.
Method: Available MRIs were collected from an existing clinical practice cohort treated with DMF and FTY. Subjects with scans at baseline, 12 month, and 24 months were selected. Scans were extracted and pre-processed. BPF and T2LV values were obtained via a previously validated automated machine-learning algorithm. A propensity score (PS) model was built using baseline patient characteristics. PS weighting was utilized to compare BPF and T2LV values with linear regression models.
Results: Baseline BPF and T2LV were similar for DMF and FTY groups (p = 0.445, p=0.861, respectively). PS adjustment achieved good covariate balance between the two groups. At 24 months, BPF was higher by 0.004 in FTY group as compared to DMF (p = 0.020). Although FTY group has 0.324ml less T2LV as compared to DMF at 24 months, there was no statistically significant difference in T2LV between the two groups (p = 0.741).
Conclusion: In a real world setting, automated imaging techniques can successfully quantify radiographic disease measures using clinical MRI scans. Both DMF and FTY treated grups observed increases in T2LV and decreases in BPF at 24 months compared to baseline. Patients who received FTY have slightly less brain atrophy at 24 months compared to DMF group. There was no statistically significant differences in T2LV between the two groups.
Disclosure: Dr. Feng reports no financial disclosures.
Dr. Nakamura reports no financial disclosures.
Dr. Hersh has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen Idec, Novartis, Teva, and Genzyme..
Dr. Ontaneda has received consulting fees from Acorda Therapeutics, Biogen Idec, Genzyme, Genentech, Malinckrodt and Novartis; and research support from Genzyme and Novartis. Dr. Ontaneda is also supported by grant from The Clinical and Translational Science Collaborative KL2 program at Case Western University School of Medicine (grant number KL2 TR000440).
Abstract: EP1682
Type: Poster Sessions
Abstract Category: Therapy - Tools for detecting therapeutic response
Background: Quantitative measures of radiographic disease makers in multiple sclerosis (MS) are important in clinical trials and in clinical practice, where clinical MRI scans are difficult to standardize. DMF and FTY are oral disease-modifying agents (DMT) that are effective in reducing relapse rate in randomized placebo-controlled trials. Their comparative efficacies in quantitative radiographic outcomes are unknown.
Objective: To quantify and compare dimethyl fumarate (DMF) and fingolimod (FTY)'s effects on brain parenchymal fraction (BPF) and T2 lesion volume (T2LV) using clinical MRI scans of MS patients from a retrospective cohort.
Method: Available MRIs were collected from an existing clinical practice cohort treated with DMF and FTY. Subjects with scans at baseline, 12 month, and 24 months were selected. Scans were extracted and pre-processed. BPF and T2LV values were obtained via a previously validated automated machine-learning algorithm. A propensity score (PS) model was built using baseline patient characteristics. PS weighting was utilized to compare BPF and T2LV values with linear regression models.
Results: Baseline BPF and T2LV were similar for DMF and FTY groups (p = 0.445, p=0.861, respectively). PS adjustment achieved good covariate balance between the two groups. At 24 months, BPF was higher by 0.004 in FTY group as compared to DMF (p = 0.020). Although FTY group has 0.324ml less T2LV as compared to DMF at 24 months, there was no statistically significant difference in T2LV between the two groups (p = 0.741).
Conclusion: In a real world setting, automated imaging techniques can successfully quantify radiographic disease measures using clinical MRI scans. Both DMF and FTY treated grups observed increases in T2LV and decreases in BPF at 24 months compared to baseline. Patients who received FTY have slightly less brain atrophy at 24 months compared to DMF group. There was no statistically significant differences in T2LV between the two groups.
Disclosure: Dr. Feng reports no financial disclosures.
Dr. Nakamura reports no financial disclosures.
Dr. Hersh has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen Idec, Novartis, Teva, and Genzyme..
Dr. Ontaneda has received consulting fees from Acorda Therapeutics, Biogen Idec, Genzyme, Genentech, Malinckrodt and Novartis; and research support from Genzyme and Novartis. Dr. Ontaneda is also supported by grant from The Clinical and Translational Science Collaborative KL2 program at Case Western University School of Medicine (grant number KL2 TR000440).