MRI, Clinical Assessments Not Prognostic in Multiple Sclerosis
No difference in outcomes for patients with no evidence of disease activity during first two years
MONDAY, Aug. 8, 2016 (HealthDay News) -- For patients with multiple sclerosis (MS), magnetic resonance imaging (MRI) and clinical assessments do not appear to offer long-term prognostic value, according to a study published online July 27 in the Annals of Neurology.
Bruce Cree, M.D., Ph.D., from the University of California San Francisco Multiple Sclerosis Center, and colleagues conducted a prospective study involving 517 actively managed MS patients, of whom 91 percent were retained with data ascertained up to 10 years after the baseline visit. They examined whether clinical and MRI data had long-term prognostic value.
The researchers found that, compared with baseline, neurological disability as measured by the Expanded Disability Status Score (EDSS) was stable or improved in 41 percent of patients at the last assessment. Long-term outcomes were no different for patients with no evidence of disease activity by clinical and MRI criteria during the first two years versus the cohort as a whole. There was an inverse association between 25-hydroxyvitamin D serum levels and short-term MS disease activity; levels were not correlated with long-term disability. At a median of 16.8 years after disease onset, 10.7 and 18.1 percent of patients, respectively, had reached EDSS ≥6, and had evolved from relapsing MS to secondary progressive MS.
"The data call into question the utility of annual MRI assessments as a treat-to-target approach for MS care," the authors write.
Several authors disclosed financial ties to pharmaceutical companies that make MS disease-modifying therapies described in the study.