Abstract Details

Title Magnetic Resonance Imaging Measures as Prognostic Parameters for Physical and Cognitive Outcomes up to 8 Years in Patients with Relapsing Forms of Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-060

Objective

Assess the predictive value of magnetic resonance imaging (MRI) measures for physical and cognitive outcomes in multiple sclerosis (MS) at ≤8 years.

Background Limited data exist on MRI measures as prognostic parameters in MS.

Design/Methods Post hoc analyses of data from patients with relapsing MS receiving fingolimod in the placebo-controlled, phase 3 FREEDOMS and FREEDOMS II trials and their extensions. Baseline MRI predictors assessed included normalized brain volume (NBV), T1 hypointense lesion volume (T1LV), T2 lesion volume (T2LV) and presence of gadolinium-enhancing (Gd+) lesions. Outcomes were transition to secondary progressive MS (SPMS), confirmed disability improvement (CDI; Expanded Disability Status Scale score decrease of 1.0 or 0.5 points, if Baseline score ≤5.5 or ≥6.0, respectively, confirmed at 6 months), CDI+ (CDI or ≥20% improvement in 9-hole peg or timed 25-foot walk tests confirmed at 6 months) and cognitive worsening (≥20% reduction in paced auditory serial addition test, confirmed at 6 months). Baseline-adjusted Cox proportional hazards model compared risk of worst vs best category; log-rank test determined predictive value of MRI parameters. Most predictors were categorized by quartile; Gd+ lesions were dichotomized by presence/absence.

Results By log-rank test, NBV was significantly predictive of all outcomes tested (p<0.001), with T1LV the second most robust measure (p<0.01 for all, except CDI+). High Baseline T1LV and T2LV predicted increased SPMS risk (hazard ratio [HR]: 2.88 and 2.83; p<0.01). Low Baseline NBV (HR: 0.59 and 0.63; p<0.01) and high Baseline T1LV (HR: 0.56 and 0.73; p<0.05) predicted less CDI and CDI+, respectively. Low NBV (HR: 3.51; p<0.001), high Baseline T1LV and T2LV (HR: 3.00 and 2.51, respectively; p<0.01) and Gd+ lesions (HR: 1.9; p<0.01) predicted cognitive worsening.

Conclusions Overall, measures of disease burden such as NBV and lesion volume are more robust prognostic parameters of long-term disease progression than (short-term) MRI lesion activity.

Authors/Disclosures
Timothy L. Vollmer, MD, FAAN PRESENTER	The institution of Dr. Vollmer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen IDEC. The institution of Dr. Vollmer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech/Roche. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Siranax. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Meyers Squib. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Viela Bios. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. The institution of Dr. Vollmer has received research support from Rocky Mountain MS Center. The institution of Dr. Vollmer has received research support from Biogen. The institution of Dr. Vollmer has received research support from Actelion. The institution of Dr. Vollmer has received research support from Genentech/Roche. The institution of Dr. Vollmer has received research support from Anokion. The institution of Dr. Vollmer has received research support from TG Therapeutics.
Dieter Haering	Dieter Haering has received personal compensation for serving as an employee of Novartis.
	No disclosure on file
Davorka Tomic	Davorka Tomic has stock in Meck KGaA.
Till Sprenger	No disclosure on file
Douglas R. Jeffery, MD, PhD (Lake Norman Neurology At Piedmont Health Care)	No disclosure on file

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