Contributions
Abstract: 163
Type: Scientific Session
Abstract Category: Clinical aspects of MS - Neuro-ophthalmology
Background: Despite the advent of new highly-active disease-modifying therapies (DMT) for relapsing-remitting Multiple Sclerosis (MS), the current therapeutic approach for progressive MS (PMS) remains challenging. Selective B-cell depletion in primary PMS (PPMS) has shown to affect disease progression in patients (pts) aged < 51 years (y), especially those with evidence of inflammatory activity, thus suggesting that the latter criteria could be crucial for DMT beneficial effect. Previous studies suggested that increased thickness of retinal inner nuclear layer (INL) reflects inflammatory activity within the central nervous system and could be therefore used as a marker for patients' stratification and therapy response monitoring.
Objective: To investigate whether INL thickness differs between PMS pts stratified in two groups based on the age cutoff of 51 y.
Methods: Optical coherence tomography scanning, including automated intra-retinal layer segmentation, was performed in 84 PMS pts (72.6% PPMS and 27.4% secondary PMS; 50% female; 61% treated; mean age 50.3±10.9y; mean disease duration: 12.3±8.7y). Demographic, data about clinical activity (relapses/progression defined as 1 point increase of the EDSS score or 0.5 if baseline EDSS≥5.5) and MRI activity (new T2/gadolinium enhancing lesions) in the previous 12 months were also collected (data available for N=77 pts). Differences between groups were assessed by analysis of covariance (ANCOVA) adjusting for sex, age, disease duration and treatment.
Findings:Pts with age < 51 y (51.2%) had significantly higher INL thickness compared to the older ones (38.2 µm vs 36.5 µm; p=0.03). The same results were found in pts with evidence of MRI activity (45.4%) (INL thickness 39.4 µm vs 36.3 µm; p=0.003). INL thickness was higher in pts with at least one of: a)MRI activity b)relapses or c)progression in the previous year compared to the ones who did not meet any of the above criteria, but such difference did not reach the statistical significance. The groups did not differ significantly in terms of any of the other retinal layers thickness (p>0.1).
Conclusions: INL thickness was higher in younger pts and in those who showed recent MRI activity. Both criteria have been used in previous studies to identify a specific subset of PMS pts supposed to respond to DMT. If our finding is confirmed, INL thickness may be considered as a useful biomarker to stratify PMS pts who may best benefit from current and experimental treatments.
Disclosure: Maria Cellerino: nothing to disclose.
Christian Cordano: nothing to disclose.
Giacomo Boffa: nothing to disclose.
Giulia Bommarito: nothing to disclose.
Maria Petracca: nothing to disclose.
Elvira Sbragia: nothing to disclose.
Caterina Lapucci: nothing to disclose.
Giovanni Novi nothing to disclose
Antonio Uccelli: received grants and contracts from FISM, Novartis, Fondazione Cariplo, Italian Ministry of Health; received honoraria or consultation fees from Biogen, Roche, Teva, Merck, Genzyme, Novartis.
Matilde Inglese: received research grants from NIH, DOD, NMSS, FISM, and Teva Neuroscience.
Abstract: 163
Type: Scientific Session
Abstract Category: Clinical aspects of MS - Neuro-ophthalmology
Background: Despite the advent of new highly-active disease-modifying therapies (DMT) for relapsing-remitting Multiple Sclerosis (MS), the current therapeutic approach for progressive MS (PMS) remains challenging. Selective B-cell depletion in primary PMS (PPMS) has shown to affect disease progression in patients (pts) aged < 51 years (y), especially those with evidence of inflammatory activity, thus suggesting that the latter criteria could be crucial for DMT beneficial effect. Previous studies suggested that increased thickness of retinal inner nuclear layer (INL) reflects inflammatory activity within the central nervous system and could be therefore used as a marker for patients' stratification and therapy response monitoring.
Objective: To investigate whether INL thickness differs between PMS pts stratified in two groups based on the age cutoff of 51 y.
Methods: Optical coherence tomography scanning, including automated intra-retinal layer segmentation, was performed in 84 PMS pts (72.6% PPMS and 27.4% secondary PMS; 50% female; 61% treated; mean age 50.3±10.9y; mean disease duration: 12.3±8.7y). Demographic, data about clinical activity (relapses/progression defined as 1 point increase of the EDSS score or 0.5 if baseline EDSS≥5.5) and MRI activity (new T2/gadolinium enhancing lesions) in the previous 12 months were also collected (data available for N=77 pts). Differences between groups were assessed by analysis of covariance (ANCOVA) adjusting for sex, age, disease duration and treatment.
Findings:Pts with age < 51 y (51.2%) had significantly higher INL thickness compared to the older ones (38.2 µm vs 36.5 µm; p=0.03). The same results were found in pts with evidence of MRI activity (45.4%) (INL thickness 39.4 µm vs 36.3 µm; p=0.003). INL thickness was higher in pts with at least one of: a)MRI activity b)relapses or c)progression in the previous year compared to the ones who did not meet any of the above criteria, but such difference did not reach the statistical significance. The groups did not differ significantly in terms of any of the other retinal layers thickness (p>0.1).
Conclusions: INL thickness was higher in younger pts and in those who showed recent MRI activity. Both criteria have been used in previous studies to identify a specific subset of PMS pts supposed to respond to DMT. If our finding is confirmed, INL thickness may be considered as a useful biomarker to stratify PMS pts who may best benefit from current and experimental treatments.
Disclosure: Maria Cellerino: nothing to disclose.
Christian Cordano: nothing to disclose.
Giacomo Boffa: nothing to disclose.
Giulia Bommarito: nothing to disclose.
Maria Petracca: nothing to disclose.
Elvira Sbragia: nothing to disclose.
Caterina Lapucci: nothing to disclose.
Giovanni Novi nothing to disclose
Antonio Uccelli: received grants and contracts from FISM, Novartis, Fondazione Cariplo, Italian Ministry of Health; received honoraria or consultation fees from Biogen, Roche, Teva, Merck, Genzyme, Novartis.
Matilde Inglese: received research grants from NIH, DOD, NMSS, FISM, and Teva Neuroscience.