Clinical consequences of MRI activity in treated multiple sclerosis

Cadavid et al. Mult Scler. 2011 May 25. [Epub ahead of print]

Inflammation detected using brain MRI is the most sensitive marker of disease activity in MS. This study investigated the clinical consequences of MRI activity in 75 PwMS treated with two different first line DMTs. Transient remission of disease occurred in 46% of subjects (partial responders) and only 23% of subjects had complete remission (responders). MRI remission was never achieved in ~30% of subjects (non-responders). The lack of MRI remission during treatment with interferon beta-1b or glatiramer acetate was associated with higher relapse rate and worsening of physical and cognitive function.

” This study illustrates the moderate impact of 1st-line DMTs on disease activity and that only a minority of PwMS completely respond to these treatments. This study suggests that if you choose the maintenance and escalation treatment strategy you can’t simply rely on clinical relapses to assess disease activity we need to do MRIs. When last did your consultant perform an MRI to assess whether or not your are responding to your treatment?”

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