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Abstract Details

Evaluation of Risk Factors and Treatment Course of 89 People with Radiologically Isolated Syndrome (RIS): A Retrospective Cohort Study
Multiple Sclerosis
MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)
246

To characterize RIS and explore previously identified risk factors for a first clinical attack in a new cohort.
RIS is a pre-symptomatic or early form of MS. Previously identified risk factors for a first event include age <37 years, male sex, spinal cord or infratentorial lesions, and intrathecal oligoclonal bands (OCBs).
A medical records search was performed for “radiologically isolated syndrome” at our institution, 2005-April 2020. Inclusion criteria: (1) MRI brain or spinal cord with evidence of demyelinating disease, (2) RIS diagnosis by the treating neurologist, and (3) MRI changes not attributed to another disease process. Exclusion criteria were a solitary demyelinating lesion or serum autoantibodies. Survival analysis was performed for the time to first clinical attack testing presumed risk factors.

Of 108 cases identified, 89 met inclusion criteria [68 female (76%); mean age 41.3y at first MRI; 66 White (74%), 9 Black (10%), 8 Hispanic/Latinx (9%); 58 had no smoking history (65%); 37 BMI>30kg/m2 (41%)]. 34 people had baseline MRI spinal cord lesions, 28 posterior fossa lesions, and 15 out of 37 tested had intrathecal OCBs. 24 people started disease modifying therapy, most for MRI changes. Glatiramer acetate (n=11) and dimethyl fumarate (n=11) were used most frequently. 18 (20%) had clinical events during the observation period (median length of follow up 35.4 months (min:0.2, max:169.3). Median time to first event was 43.0 months (min:4.9, max:87.6). Age at baseline MRI, sex and presence of lesions on initial spinal cord MRI were each not observed to be associated with time to first clinical event (p>0.05).
In this novel RIS cohort, to date, 20% had a first clinical event and 27% had initiation of a DMT. We could not validate previously identified risk factors for first clinical events, possibly due to sample size or common early DMT initiation.
Authors/Disclosures
Ilena George, MD
PRESENTER 		The institution of Dr. George has received research support from Biogen.
Dylan R. Rice Mr. Rice has nothing to disclose.
Lori Chibnik No disclosure on file
Farrah J. Mateen, MD, PhD, FAAN (Northwestern University Department of Neurology) Dr. Mateen has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Mateen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Mateen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Dr. Mateen has received research support from Genentech. The institution of Dr. Mateen has received research support from Amgen. The institution of Dr. Mateen has received research support from TG Therapeutics. Dr. Mateen has received intellectual property interests from a discovery or technology relating to health care.