Author Of 2 Presentations
P0169 - The association between spontaneous MxA mRNA level and disease activity in multiple sclerosis (ID 1732)
Abstract
Background
Myxovirus resistance protein A (MxA) is one of the proteins upregulated by interferon-beta. MxA mRNA level is often used in clinical practice to determine bioactivity of interferon-beta treatment in patients with relapsing-remitting multiple sclerosis (RRMS). Lack of bioactivity is often due to the development of neutralizing antibodies against the drug. In 2010, we reported the association between spontaneous MxA mRNA level and clinical disease activity in multiple sclerosis (MS). Low levels of spontaneous MxA mRNA level were associated with contrast enhancing lesions (CELs) on baseline MRI, clinical relapses and a shorter time to first relapse. In the current study we assessed the long term data in the same cohort for the association between spontaneous MxA mRNA levels and clinical disease activity and disability.
Objectives
To investigate the association between spontaneous myxovirus resistance protein A (MxA) mRNA levels and disease activity in MS patients over a longer follow-up period.
Methods
Spontaneous MxA mRNA levels were determined in a previously described cohort of 116 patients diagnosed with a clinically isolated syndrome (CIS) or with a recent diagnosis of RRMS, and related to clinical scores (Expanded Disability Status Scale (EDSS), timed-25-foot walk (T25FW), 9-hole-peg test (9HPT)), and MS type over a long follow-up. MRI-imaging was performed at baseline and during follow-up to assess the development of new T2-lesions and CELs.
Results
116 patients where included in the analyses. 74 (63.8%) were female. At baseline, 67 patients (57.8%) were diagnosed with RRMS and 49 (42.2%) with a CIS. Median follow-up duration was 10.76 years (IQR 69.52-148.50 months). Median EDSS at follow-up was 3.0. Spontaneous MxA mRNA level was not associated with EDSS, T25FW and 9HPT, and MS subtype at follow-up. 89.7% of patients ever experienced MRI-activity during follow-up. Low spontaneous MxA mRNA levels were associated with the occurrence of more T2-lesions on MRI imaging during follow-up in patients with a small number of T2-lesions (<9 lesions) on baseline MRI (B=-1.595, p=0.029).
Conclusions
Baseline spontaneous MxA mRNA level is associated with the development of new T2-lesions on MRI during long-term follow-up and, if confirmed in other populations, has a potential value as a predictive biomarker for long-term inflammatory disease activity in MS.
P0481 - Natalizumab discontinuation in a Dutch real-world cohort (ID 1754)
Abstract
Background
Natalizumab is a widely used treatment option for patients with relapsing-remitting multiple sclerosis (RRMS). Identifying characteristics of patients discontinuing natalizumab treatment and reasons for discontinuation could help improve clinical decision making regarding natalizumab treatment in multiple sclerosis (MS).
Objectives
To determine characteristics of RRMS patients that discontinued natalizumab treatment in a Dutch real-world cohort.
Methods
Data were collected from an ongoing observational cohort study of all natalizumab treated patients in the Amsterdam UMC. Standard clinical parameters, total number of natalizumab infusions, reasons for discontinuation and therapies the patients switched to after discontinuation of natalizumab were collected.
Results
254 patients have ever received natalizumab treatment in our cohort, of which 148 patients stopped treatment. Mean age at discontinuation of natalizumab was 40.2 years, and 65.8% was female. Patients received an average of 68 infusions. Median treatment duration with natalizumab was 4.77 years. Mean Expanded Disablity Status Scale (EDSS) was similar at the start and stop of natalizumab treatment. The majority of patients (109 in total (73.6%)) stopped natalizumab treatment solely due to JC virus (JCV) positivity. Eight patients (5.4%) discontinued due to progression of MS, 3 (2.0%) due to pregnancy, 12 (8.1%) due to an allergic reaction or antibodies, 2 (1.4%) due to side effects, 4 (2.7%) due to the patients preference for another therapy, 3 (2.0%) due to clinical stabilisation and the remaining 7 patients (4.7%) due to other reasons. Most patients switched to another type of disease modifying therapy (DMT) after natalizumab discontinuation. Patients most frequently switched to fingolimod (76 patients (51.4%)) or ocrelizumab (26 patients (17.6%)) after discontinuation of natalizumab. Fourteen patients (9.5%) did not start another DMT after natalizumab discontinuation. Thirty-nine patients (26.4%) switched a second time to a different DMT and 19 patients (12.8%) stopped DMT after an initial switch.
Conclusions
Our results suggest JCV positivity to be the most frequent reason for natalizumab discontinuation. The heterogeneity in treatment switches suggests individual treatment plans are frequently present in MS. Recognising reasons for treatment discontinuation and treatment decisions made in our patient cohort can be helpful in future clinical decision making.
Presenter Of 2 Presentations
P0169 - The association between spontaneous MxA mRNA level and disease activity in multiple sclerosis (ID 1732)
Abstract
Background
Myxovirus resistance protein A (MxA) is one of the proteins upregulated by interferon-beta. MxA mRNA level is often used in clinical practice to determine bioactivity of interferon-beta treatment in patients with relapsing-remitting multiple sclerosis (RRMS). Lack of bioactivity is often due to the development of neutralizing antibodies against the drug. In 2010, we reported the association between spontaneous MxA mRNA level and clinical disease activity in multiple sclerosis (MS). Low levels of spontaneous MxA mRNA level were associated with contrast enhancing lesions (CELs) on baseline MRI, clinical relapses and a shorter time to first relapse. In the current study we assessed the long term data in the same cohort for the association between spontaneous MxA mRNA levels and clinical disease activity and disability.
Objectives
To investigate the association between spontaneous myxovirus resistance protein A (MxA) mRNA levels and disease activity in MS patients over a longer follow-up period.
Methods
Spontaneous MxA mRNA levels were determined in a previously described cohort of 116 patients diagnosed with a clinically isolated syndrome (CIS) or with a recent diagnosis of RRMS, and related to clinical scores (Expanded Disability Status Scale (EDSS), timed-25-foot walk (T25FW), 9-hole-peg test (9HPT)), and MS type over a long follow-up. MRI-imaging was performed at baseline and during follow-up to assess the development of new T2-lesions and CELs.
Results
116 patients where included in the analyses. 74 (63.8%) were female. At baseline, 67 patients (57.8%) were diagnosed with RRMS and 49 (42.2%) with a CIS. Median follow-up duration was 10.76 years (IQR 69.52-148.50 months). Median EDSS at follow-up was 3.0. Spontaneous MxA mRNA level was not associated with EDSS, T25FW and 9HPT, and MS subtype at follow-up. 89.7% of patients ever experienced MRI-activity during follow-up. Low spontaneous MxA mRNA levels were associated with the occurrence of more T2-lesions on MRI imaging during follow-up in patients with a small number of T2-lesions (<9 lesions) on baseline MRI (B=-1.595, p=0.029).
Conclusions
Baseline spontaneous MxA mRNA level is associated with the development of new T2-lesions on MRI during long-term follow-up and, if confirmed in other populations, has a potential value as a predictive biomarker for long-term inflammatory disease activity in MS.
P0481 - Natalizumab discontinuation in a Dutch real-world cohort (ID 1754)
Abstract
Background
Natalizumab is a widely used treatment option for patients with relapsing-remitting multiple sclerosis (RRMS). Identifying characteristics of patients discontinuing natalizumab treatment and reasons for discontinuation could help improve clinical decision making regarding natalizumab treatment in multiple sclerosis (MS).
Objectives
To determine characteristics of RRMS patients that discontinued natalizumab treatment in a Dutch real-world cohort.
Methods
Data were collected from an ongoing observational cohort study of all natalizumab treated patients in the Amsterdam UMC. Standard clinical parameters, total number of natalizumab infusions, reasons for discontinuation and therapies the patients switched to after discontinuation of natalizumab were collected.
Results
254 patients have ever received natalizumab treatment in our cohort, of which 148 patients stopped treatment. Mean age at discontinuation of natalizumab was 40.2 years, and 65.8% was female. Patients received an average of 68 infusions. Median treatment duration with natalizumab was 4.77 years. Mean Expanded Disablity Status Scale (EDSS) was similar at the start and stop of natalizumab treatment. The majority of patients (109 in total (73.6%)) stopped natalizumab treatment solely due to JC virus (JCV) positivity. Eight patients (5.4%) discontinued due to progression of MS, 3 (2.0%) due to pregnancy, 12 (8.1%) due to an allergic reaction or antibodies, 2 (1.4%) due to side effects, 4 (2.7%) due to the patients preference for another therapy, 3 (2.0%) due to clinical stabilisation and the remaining 7 patients (4.7%) due to other reasons. Most patients switched to another type of disease modifying therapy (DMT) after natalizumab discontinuation. Patients most frequently switched to fingolimod (76 patients (51.4%)) or ocrelizumab (26 patients (17.6%)) after discontinuation of natalizumab. Fourteen patients (9.5%) did not start another DMT after natalizumab discontinuation. Thirty-nine patients (26.4%) switched a second time to a different DMT and 19 patients (12.8%) stopped DMT after an initial switch.
Conclusions
Our results suggest JCV positivity to be the most frequent reason for natalizumab discontinuation. The heterogeneity in treatment switches suggests individual treatment plans are frequently present in MS. Recognising reasons for treatment discontinuation and treatment decisions made in our patient cohort can be helpful in future clinical decision making.