Routine MRI, Clinical Assessments Fail to Predict Prognosis in MS

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Routine MRI, Clinical Assessments Fail to Predict Prognosis in MS
Routine MRI, Clinical Assessments Fail to Predict Prognosis in MS

HealthDay News -- Magnetic resonance imaging (MRI) and clinical assessments do not appear to offer long-term prognostic value in patients with multiple sclerosis (MS), according to a study published in the Annals of Neurology.

Bruce Cree, MD, PhD, 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% 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% 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 2 years vs 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% 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.

Reference

Cree B, Gourraud PA, Oksenberg JR, et al. Long-term evolution of multiple sclerosis disability in the treatment era. Ann Neurol. 2016; doi:10.1002/ana.24747.

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