Abstract Details

Title Endovascular Treatment for Chronic Cerebrospinal Venous Insufficiency in Patients with Multiple Sclerosis: Patient-Reported Outcomes (PRO)

Topic MS and Related Diseases

Presentation(s) P01 - (-)

Poster/Presentation
Number 182

Objective

Background BACKGROUND: The chronic cerebrospinal venous insufficiency (CCSVI) hypothesis has been proposed as the causal factor for MS. Contradictory data on the association between CCSVI and MS have been reported to date. CCSVI was defined as impaired extra cranial cerebrospinal venous drainage which leads to the accumulation of cerebral iron deposits causing inflammation and degeneration.

Design/Methods DESIGN/METHODS: 82 eligible patients completed a questionnaire regarding changes in their MS symptoms after ET including fatigue, sensory deficits, impairments in mobility, coordination, bladder control and cognition. First, we examined symptom changes within 2 weeks after treatment compared to before. For longitudinal assessment, we divided patients to 3 groups; patients who had ET 1) within past 6 month 2) 6-12 months or 3) more than 12 months. Changes at the time of interview were compared to those before the ET. Their EDSS score was measured before and after ET and analyzed using student t test.

Results RESULTS: Within 2 weeks after treatment, 70% (56/79) reported decreased fatigue. About two-thirds reported improvement in cognition (38/65), mobility (51/79) and perceived warming in their limb temperature (40/63). Half of patients reported improvement in bladder control (34/73), coordination (37/73) and sensory deficits (28/61). Longitudinal assessment of symptoms revealed that initial reported improvement in most symptoms greatly diminished over time. Furthermore, we did not find any significant difference between EDSS scores before and after the ET (P=0.828).

Conclusions CONCLUSIONS: Our findings indicate that ET procedures for CCSVI are associated with subjective reports of improvement of various symptoms by many patients without any corresponding objective change in neurological evaluations as measured by neurologist-derived EDSS scores. These uncontrolled and unblinded observations do not provide any credible evidence of a true benefit from ET for MS.

Authors/Disclosures
Moogeh Baharnoori (Kingston General Hospital) PRESENTER	Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genzyme . Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD serono. Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis . Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb.
	No disclosure on file
Fred D. Lublin, MD, FAAN (Icahn School of Medicine At Mount Sinai)	Dr. Lublin has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche/Genentech. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurogene. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medimmune/Viela Bio/Horizon. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Receptos/Celgene/BMS. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Labcorp. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neuralight. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Entelexo. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Avotres. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Lublin has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono. Dr. Lublin has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for Multiple entities. Dr. Lublin has stock in Avotres. Dr. Lublin has stock in Neuralight. The institution of Dr. Lublin has received research support from Brainstorm. The institution of Dr. Lublin has received research support from biogen. The institution of Dr. Lublin has received research support from NIH.
Marika Hohol, MD (St. Michaels Hospital)	Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Seronon. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion Pharmaceuticals. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono.
Paul W. O'Connor, MD	No disclosure on file

��ɫ��

��ɫ��