MRI activity and neutralising antibody as predictors of response to interferon beta treatment in multiple sclerosis
Articolo
Data di Pubblicazione:
2008
Citazione:
MRI activity and neutralising antibody as predictors of response to interferon beta treatment in multiple sclerosis / L. Durelli, P. Barbero, M. Bergui, E. Versino, M.A. Bassano, E. Verdun, C. Rivoiro, C. Ferrero, E. Picco, P. Ripellino, G. Giuliani, E. Montanari, M. Clerico, G. Meola, Italian Multiple Sclerosis Study G. - In: JOURNAL OF NEUROLOGY, NEUROSURGERY AND PSYCHIATRY. - ISSN 0022-3050. - 79:6(2008 Jun), pp. 646-651. [10.1136/jnnp.2007.130229]
Abstract:
Objective: To prospectively validate MRI activity and
neutralising anti-interferon antibody (NAb) during the first
6 months of interferon b treatment as response indicators
in multiple sclerosis (MS).
Methods: Patients with relapsing–remitting MS were
followed during the first 2 years of treatment.
Neurological assessments were performed every
3 months or when a relapse was suspected. MRI scans
performed at baseline and at 3, 4, 5 and 6 months after
the start of treatment were assessed centrally for disease
activity: new T2 or gadolinium enhancing T1 lesions. NAb
were assessed using the MxA protein assay; positivity
was defined as two consecutive titres >20 NU/ml. We
evaluated the predictivity of an active scan, NAb
positivity, or both, during the first 6 months of treatment,
on the occurrence of clinical disease activity in the
following 18 months.
Results: 147 patients were assessed at 16 centres.
Predictivity parameters (with confidence intervals) were
as follows: active scan, sensitivity (SN) 52% (34–69%),
specificity (SP) 80% (65–91%), negative predictive value
(NPV) 73% (58–77%), positive predictive value (PPV) 62%
(42–79%), p=0.002; NAb positivity, SN 71% (45–88%),
SP 66% (55–76%), NPV 92% (82–97%), PPV 29% (16–
45%), p=0.01; active scan and NAb positivity, SN 71%
(38–91%), SP 86% (73–94%), NPV 94% (86–98%), PPV
50% (29–70%), p=0.0003.
Conclusions: MRI activity and NAb occurrence during
the first 6 months of interferon b treatment were reliable
predictors of long term clinical response, particularly when
combined. Patients with negative predictors showed a
less than 10% risk of developing clinical activity. Patients
with positive predictors showed a 50% risk of further
clinical activity. These patients need to be followed
carefully with further MRI and NAb tests.
Tipologia IRIS:
01 - Articolo su periodico
Elenco autori:
L. Durelli, P. Barbero, M. Bergui, E. Versino, M.A. Bassano, E. Verdun, C. Rivoiro, C. Ferrero, E. Picco, P. Ripellino, G. Giuliani, E. Montanari, M. Clerico, G. Meola, I.M.S.S. G.
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