Factors influencing long-term outcomes in relapsing–remitting multiple sclerosis: PRISMS-15. Issue 11 (15th September 2015)

• Record Type: Journal Article
• Authors: Kappos, Ludwig; Kuhle, Jens; Multanen, Juha; Kremenchutzky, Marcelo; Verdun di Cantogno, Elisabetta; Cornelisse, Peter; Lehr, Lorenz; Casset-Semanaz, Florence; Issard, Delphine; Uitdehaag, Bernard M J
• Other Names: King John author non-byline.; Barnett Michael author non-byline.; Freedman Mark author non-byline.; Oger Joel author non-byline.; Sandberg-Wollheim Magnhild author non-byline.; Constantinescu Cris author non-byline.; Palace Jacqueline author non-byline.; Barnes David author non-byline.; Williams Victoria author non-byline.; Dubois Benedicte author non-byline.; Medaer Robert author non-byline.; Sindic Christian author non-byline.; Eralinna Juha-Pekka author non-byline.; Wiendl Heinz author non-byline.; Kleinschnitz Christoph author non-byline.
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 86:Issue 11(2015)
• Page Start: 1202
• Page End: 1207
• Publication Date: 2015-09-15
• Subjects: MULTIPLE SCLEROSIS -- INTERFERON -- MRI; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2014-310024
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Aim: An exploratory study of the relationship between cumulative exposure to subcutaneous (sc) interferon (IFN) β-1a treatment and other possible prognostic factors with long-term clinical outcomes in relapsing–remitting multiple sclerosis (RRMS). Methods: Patients in the original PRISMS study were invited to a single follow-up visit 15 years after initial randomisation (PRISMS-15). Outcomes over 15 years were compared in the lowest and highest quartile of the cumulative sc IFN β-1a dose groups, and according to total time receiving sc IFN β-1a as a continuous variable per 5 years of treatment. Potential prognostic factors for outcomes were analysed. Results: Of 560 patients randomised in PRISMS, 291 returned for PRISMS-15 and 290 (51.8%) were analysed. Higher cumulative dose exposure and longer treatment time appeared to be associated with better outcomes on: annualised relapse rate, number of relapses, time to Expanded Disability Status Scale (EDSS) progression, change in EDSS, proportions of patients with EDSS ≥4 or ≥6, ≤5 relapses and EDSS <4 or <6, and time to conversion to secondary-progressive MS (SPMS). Higher dose exposure was associated with lower proportions of patients with EDSS progression and conversion to SPMS, and longer time on treatment with lower risk of first relapse. Change in EDSS from baseline to 24 months was a strong predictor of evaluated clinical outcomes over 15 years. Conclusions: These findings suggest that higher cumulative exposure to sc IFN β-1a may be associated with better clinical outcomes, and early change in EDSS score may have prognostic value, over many years, in RRMS.