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Abstract Details

Clinical Predictors of Treatment Failure in First-Line Immunomodulatory Therapy in Multiple Sclerosis
MS and Related Diseases
P01 - (-)
196
BACKGROUND: The highly variable natural history of multiple sclerosis creates a need to identify patients who are unlikely to benefit from the three formulations of interferon-b (IFN-[szlig] 1a SC, IFN-[szlig] 1a IM, IFN-[szlig] 1b) and glatiramer acetate (GA). Presently, there are no reliable clinical biomarkers that predict non-response to first-line medications from disease outset.
DESIGN/METHODS: Patients enrolled in the CLIMB study were included for analysis if they took a first-line medication for more than two years. For each patient, the clinical, radiological and attack histories in our Oracle database were validated using a clinical chart review. The primary outcome measure for this study was the time to the first clinical or radiological event. Clinical events were defined as either a new relapse or sustained progression on EDSS. MRI events were defined as the appearance of either T2 or gadolinium-enhancing lesions based on the radiologist's finalized report. With a separate analysis for each medicine, the impact of several clinical descriptors on the time to event (gender, race, age, disease duration, age at onset, initial motor symptoms, EDSS at most recent visit) was assessed using Cox proportional hazards regression model.
RESULTS: The final sample consisted of 48 IFN-[szlig] 1a SC, 27 IFN-[szlig] 1b, 89 IFN-[szlig] 1a IM, and 96 GA treated patients. Median time to first event for each of the groups was between 1.1 and 2.3 years. Younger age at treatment initiation and younger age at onset were significantly associated with an increased hazard of an event for IFN-[szlig] 1a SC treated patients. None of the other predictors were associated with an increased hazard of an event for other treatment groups.
CONCLUSIONS: Clinical predictors provide limited information regarding the hazard of an event in patients treated with injectable first line MS treatments.
Authors/Disclosures
Robert L. Carruthers, MD
PRESENTER 		Dr. Carruthers has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Carruthers has received personal compensation in the range of $0-$499 for serving as a Consultant for Roche and Genentech. The institution of Dr. Carruthers has received research support from Roche and Genentech .
Muhammad Taimur A. Malik, MD (St Lukes) Dr. Malik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genetech . Dr. Malik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jansen . Dr. Malik 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. The institution of Dr. Malik has received research support from National MS Society .
Brian C. Healy The institution of Mr. Healy has received research support from Analysis Group. The institution of Mr. Healy has received research support from Bristol-Myers Squibb. The institution of Mr. Healy has received research support from Verily Life Sciences. The institution of Mr. Healy has received research support from Novartis. The institution of Mr. Healy has received research support from Merck Serono. The institution of Mr. Healy has received research support from Genzyme.
Taha Gholipour, MD (UC San Diego Health - Comprehensive Epilepsy Center) Dr. Gholipour has nothing to disclose.
Howard L. Weiner, MD (Brigham and Women'S Hospital) Dr. Weiner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Weiner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medday Pharmaceuticals. Dr. Weiner has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for vTv Therapeutics. Dr. Weiner has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Tiziana Life Sciences. Dr. Weiner has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for vTv Therapeutics. Dr. Weiner has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medday Pharmaceuticals. Dr. Weiner has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for vTv Therapeutics. Dr. Weiner has stock in vTv Therapeutics. The institution of Dr. Weiner has received research support from National Institute of Health. The institution of Dr. Weiner has received research support from National MS Society. The institution of Dr. Weiner has received research support from Genzyme Corp. The institution of Dr. Weiner has received research support from Genentech, Inc. . The institution of Dr. Weiner has received research support from Verily Life Sciences LLC. The institution of Dr. Weiner has received research support from EMD Serono, Inc..
Tanuja Chitnis, MD, FAAN (Brigham and Women's Hospital) Dr. Chitnis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Chitnis has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche-Genentech. Dr. Chitnis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octave Biosciences. Dr. Chitnis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. The institution of Dr. Chitnis 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. Chitnis has received research support from Novartis. The institution of Dr. Chitnis has received research support from Sanofi. The institution of Dr. Chitnis has received research support from Octave. The institution of Dr. Chitnis has received research support from Genentech-Roche. The institution of Dr. Chitnis has received research support from Tiziana Life Sciences. The institution of Dr. Chitnis has received research support from Bristol-Myers Squibb. The institution of Dr. Chitnis has received research support from Wesley Clover.
Ronald C. Petersen, MD, PhD, FAAN (Mayo Clinic) Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly and Co.. Dr. Petersen has received personal compensation in the range of $0-$499 for serving as a Consultant for Eisai, Inc.. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Nordisk. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has a non-compensated relationship as a Board of Directors with American Brain Foundation that is relevant to AAN interests or activities.