Abstract
Objective
To compare the long-term effect of disease-modifying therapies (DMT) on brain volume
loss in relapsing–remitting MS (RRMS) patients.
Methods
We conducted a study to examine the effect of daily glatiramer acetate (GA), weekly
low dose interferon beta (LD-IFNB), and high-dose high-frequency interferon beta disease
(HD-IFNB) on brain volume loss over 5 years in RRMS patients. All patients were previously treatment naïve, had disease
duration ≤5 years at the time of initiating DMT, and subsequently received the same DMT for 5 years continuously. The percentage change in brain volume (PCBV) was measured using
fully automated software. MRI analysis was performed blinded to treatment allocation.
Results
The adjusted PCBV from baseline to year 5 was −2.27% in GA, −2.62% in LD-IFNB, and −3.21% in the HD-IFNB groups (−2.27 vs −2.62, p=0.0036; −2.27 vs −3.21, p<0.0001; −2.62 vs −3.21, p<0.0001). These data remained unchanged from year 1 to year 5, after adjusting for
pseudoatrophy in the first year. A group of RRMS patients that remained untreated
for a period ranging from 8 to 24 months, served as controls. All treatment groups were significantly better than the
rate of projected brain volume loss in the untreated group over 5 years (p<0.0001).
Conclusions
Global brain volume loss is a dynamic process even in relatively early RRMS patients
that occurs despite intervention with therapy. However, all DMT significantly reduced
the loss of brain volume compared to no treatment. The GA-treated group experienced
the least reduction in brain volume over 5 years, compared to the LD-IFNB and HD-IFNB treated groups. These differences could
be partly related to the immunologic consequences of GA therapy in RRMS.
Keywords
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Article info
Publication history
Published online: September 15, 2011
Accepted:
August 24,
2011
Received:
July 17,
2011
Identification
Copyright
© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
