MRI activity and neutralising antibody as predictors of response to interferon beta treatment in multiple sclerosis.

Giovanni Savettieri, Giuseppe Salemi, Enzo Pucci, Versino, Rivoiro, Barbero, Bergui, Montanari, Durelli, Verdun, Bassano, Picco, Ripellino, Ferrera, Marinella Clerico, Giuliani

Risultato della ricerca: Article

58 Citazioni (Scopus)

Abstract

Objective: To prospectively validate MRI activity and neutralising anti-interferon antibody (NAb) during the first 6 months of interferon β ;treatment as response indicators in multiple sclerosis (MS). Methods: Patients with relapsing-remitting MS were followed during the first 2 years of treatment. Neurological assessments were performed every 3 months or when a relapse was suspected. MRI scans performed at baseline and at 3, 4, 5 and 6 months after the start of treatment were assessed centrally for disease activity: new T2 or gadolinium enhancing T1 lesions. NAb were assessed using the MxA protein assay; positivity was defined as two consecutive titres ≥20 NU/ml. We evaluated the predictivity of an active scan, NAb positivity, or both, during the first 6 months of treatment, on the occurrence of clinical disease activity in the following 18 months. Results: 147 patients were assessed at 16 centres. Predictivity parameters (with confidence intervals) were as follows: active scan, sensitivity (SN) 52% (34-69%), specificity (SP) 80% (65-91%), negative predictive value (NPV) 73% (58-77%), positive predictive value (PPV) 62% (42-79%), p = 0.002; NAb positivity, SN 71% (45-88%), SP 66% (55-76%), NPV 92% (82-97%), PPV 29% (16-45%), p = 0.01; active scan and NAb positivity, SN 71% (38-91%), SP 86% (73-94%), NPV 94% (86-98%), PPV 50% (29-70%), p = 0.0003. Conclusions: MRI activity and NAb occurrence during the first 6 months of interferon β treatment were reliable predictors of long term clinical response, particularly when combined. Patients with negative predictors showed a less than 10% risk of developing clinical activity. Patients with positive predictors showed a 50% risk of further clinical activity. These patients need to be followed carefully with further MRI and NAb tests.
Lingua originaleEnglish
pagine (da-a)646-651
Numero di pagine6
RivistaJournal of Neurology, Neurosurgery and Psychiatry
Volume79
Stato di pubblicazionePublished - 2008

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Interferon-beta
Neutralizing Antibodies
Multiple Sclerosis
Therapeutics
Relapsing-Remitting Multiple Sclerosis
Gadolinium
Interferons
Anti-Idiotypic Antibodies
Magnetic Resonance Imaging
Confidence Intervals
Recurrence
Proteins

All Science Journal Classification (ASJC) codes

  • Surgery
  • Psychiatry and Mental health
  • Clinical Neurology

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MRI activity and neutralising antibody as predictors of response to interferon beta treatment in multiple sclerosis. / Savettieri, Giovanni; Salemi, Giuseppe; Pucci, Enzo; Versino; Rivoiro; Barbero; Bergui; Montanari; Durelli; Verdun; Bassano; Picco; Ripellino; Ferrera; Clerico, Marinella; Giuliani.

In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 79, 2008, pag. 646-651.

Risultato della ricerca: Article

Savettieri, G, Salemi, G, Pucci, E, Versino, Rivoiro, Barbero, Bergui, Montanari, Durelli, Verdun, Bassano, Picco, Ripellino, Ferrera, Clerico, M & Giuliani 2008, 'MRI activity and neutralising antibody as predictors of response to interferon beta treatment in multiple sclerosis.', Journal of Neurology, Neurosurgery and Psychiatry, vol. 79, pagg. 646-651.
Savettieri, Giovanni ; Salemi, Giuseppe ; Pucci, Enzo ; Versino ; Rivoiro ; Barbero ; Bergui ; Montanari ; Durelli ; Verdun ; Bassano ; Picco ; Ripellino ; Ferrera ; Clerico, Marinella ; Giuliani. / MRI activity and neutralising antibody as predictors of response to interferon beta treatment in multiple sclerosis. In: Journal of Neurology, Neurosurgery and Psychiatry. 2008 ; Vol. 79. pagg. 646-651.
@article{be97d05ccbb046a3ac4aa5f6e7082429,
title = "MRI activity and neutralising antibody as predictors of response to interferon beta treatment in multiple sclerosis.",
abstract = "Objective: To prospectively validate MRI activity and neutralising anti-interferon antibody (NAb) during the first 6 months of interferon β ;treatment as response indicators in multiple sclerosis (MS). Methods: Patients with relapsing-remitting MS were followed during the first 2 years of treatment. Neurological assessments were performed every 3 months or when a relapse was suspected. MRI scans performed at baseline and at 3, 4, 5 and 6 months after the start of treatment were assessed centrally for disease activity: new T2 or gadolinium enhancing T1 lesions. NAb were assessed using the MxA protein assay; positivity was defined as two consecutive titres ≥20 NU/ml. We evaluated the predictivity of an active scan, NAb positivity, or both, during the first 6 months of treatment, on the occurrence of clinical disease activity in the following 18 months. Results: 147 patients were assessed at 16 centres. Predictivity parameters (with confidence intervals) were as follows: active scan, sensitivity (SN) 52{\%} (34-69{\%}), specificity (SP) 80{\%} (65-91{\%}), negative predictive value (NPV) 73{\%} (58-77{\%}), positive predictive value (PPV) 62{\%} (42-79{\%}), p = 0.002; NAb positivity, SN 71{\%} (45-88{\%}), SP 66{\%} (55-76{\%}), NPV 92{\%} (82-97{\%}), PPV 29{\%} (16-45{\%}), p = 0.01; active scan and NAb positivity, SN 71{\%} (38-91{\%}), SP 86{\%} (73-94{\%}), NPV 94{\%} (86-98{\%}), PPV 50{\%} (29-70{\%}), p = 0.0003. Conclusions: MRI activity and NAb occurrence during the first 6 months of interferon β treatment were reliable predictors of long term clinical response, particularly when combined. Patients with negative predictors showed a less than 10{\%} risk of developing clinical activity. Patients with positive predictors showed a 50{\%} risk of further clinical activity. These patients need to be followed carefully with further MRI and NAb tests.",
author = "Giovanni Savettieri and Giuseppe Salemi and Enzo Pucci and Versino and Rivoiro and Barbero and Bergui and Montanari and Durelli and Verdun and Bassano and Picco and Ripellino and Ferrera and Marinella Clerico and Giuliani",
year = "2008",
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pages = "646--651",
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TY - JOUR

T1 - MRI activity and neutralising antibody as predictors of response to interferon beta treatment in multiple sclerosis.

AU - Savettieri, Giovanni

AU - Salemi, Giuseppe

AU - Pucci, Enzo

AU - Versino, null

AU - Rivoiro, null

AU - Barbero, null

AU - Bergui, null

AU - Montanari, null

AU - Durelli, null

AU - Verdun, null

AU - Bassano, null

AU - Picco, null

AU - Ripellino, null

AU - Ferrera, null

AU - Clerico, Marinella

AU - Giuliani, null

PY - 2008

Y1 - 2008

N2 - Objective: To prospectively validate MRI activity and neutralising anti-interferon antibody (NAb) during the first 6 months of interferon β ;treatment as response indicators in multiple sclerosis (MS). Methods: Patients with relapsing-remitting MS were followed during the first 2 years of treatment. Neurological assessments were performed every 3 months or when a relapse was suspected. MRI scans performed at baseline and at 3, 4, 5 and 6 months after the start of treatment were assessed centrally for disease activity: new T2 or gadolinium enhancing T1 lesions. NAb were assessed using the MxA protein assay; positivity was defined as two consecutive titres ≥20 NU/ml. We evaluated the predictivity of an active scan, NAb positivity, or both, during the first 6 months of treatment, on the occurrence of clinical disease activity in the following 18 months. Results: 147 patients were assessed at 16 centres. Predictivity parameters (with confidence intervals) were as follows: active scan, sensitivity (SN) 52% (34-69%), specificity (SP) 80% (65-91%), negative predictive value (NPV) 73% (58-77%), positive predictive value (PPV) 62% (42-79%), p = 0.002; NAb positivity, SN 71% (45-88%), SP 66% (55-76%), NPV 92% (82-97%), PPV 29% (16-45%), p = 0.01; active scan and NAb positivity, SN 71% (38-91%), SP 86% (73-94%), NPV 94% (86-98%), PPV 50% (29-70%), p = 0.0003. Conclusions: MRI activity and NAb occurrence during the first 6 months of interferon β treatment were reliable predictors of long term clinical response, particularly when combined. Patients with negative predictors showed a less than 10% risk of developing clinical activity. Patients with positive predictors showed a 50% risk of further clinical activity. These patients need to be followed carefully with further MRI and NAb tests.

AB - Objective: To prospectively validate MRI activity and neutralising anti-interferon antibody (NAb) during the first 6 months of interferon β ;treatment as response indicators in multiple sclerosis (MS). Methods: Patients with relapsing-remitting MS were followed during the first 2 years of treatment. Neurological assessments were performed every 3 months or when a relapse was suspected. MRI scans performed at baseline and at 3, 4, 5 and 6 months after the start of treatment were assessed centrally for disease activity: new T2 or gadolinium enhancing T1 lesions. NAb were assessed using the MxA protein assay; positivity was defined as two consecutive titres ≥20 NU/ml. We evaluated the predictivity of an active scan, NAb positivity, or both, during the first 6 months of treatment, on the occurrence of clinical disease activity in the following 18 months. Results: 147 patients were assessed at 16 centres. Predictivity parameters (with confidence intervals) were as follows: active scan, sensitivity (SN) 52% (34-69%), specificity (SP) 80% (65-91%), negative predictive value (NPV) 73% (58-77%), positive predictive value (PPV) 62% (42-79%), p = 0.002; NAb positivity, SN 71% (45-88%), SP 66% (55-76%), NPV 92% (82-97%), PPV 29% (16-45%), p = 0.01; active scan and NAb positivity, SN 71% (38-91%), SP 86% (73-94%), NPV 94% (86-98%), PPV 50% (29-70%), p = 0.0003. Conclusions: MRI activity and NAb occurrence during the first 6 months of interferon β treatment were reliable predictors of long term clinical response, particularly when combined. Patients with negative predictors showed a less than 10% risk of developing clinical activity. Patients with positive predictors showed a 50% risk of further clinical activity. These patients need to be followed carefully with further MRI and NAb tests.

UR - http://hdl.handle.net/10447/20938

M3 - Article

VL - 79

SP - 646

EP - 651

JO - Journal of Neurology, Neurosurgery and Psychiatry

JF - Journal of Neurology, Neurosurgery and Psychiatry

SN - 0022-3050

ER -