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Does MRI lesion activity regress in secondary progressive multiple sclerosis?

Authors :: Zhao Y
Petkau AJ
Traboulsee A
Riddehough A
Li DK
Source :: Multiple sclerosis (Houndmills, Basingstoke, England) [Mult Scler] 2010 Apr; Vol. 16 (4), pp. 434-42. Date of Electronic Publication: 2010 Feb 18.
Publication Year :: 2010
Abstract: Background: The rate of new contrast-enhancing lesions (CELs) on monthly magnetic resonance imaging (MRI) scans has been shown to decrease over a 9-month period in placebo-treated patients with relapsing-remitting (RR) multiple sclerosis (RRMS).<br />Objective: We examined this phenomenon in placebo-treated secondary progressive MS (SPMS) patients.<br />Methods: Patients were chosen from two clinical trials. Monthly scans were taken at screening, baseline and months 1-9 for Cohort-1 and months 1-6 for Cohort-2. We examined the monthly new CEL rates according to initial CEL level: 0, 1-3, >3 CELs at screening, and presence and absence of pre-study relapses.<br />Results: Respectively, 59, 21 and 14 of the 94 Cohort-1 patients, and 36, 17 and 9 of the 62 Cohort-2 patients had 0, 1-3 and >3 initial CELs. For Cohort-1, the monthly new CEL rates did not change during follow-up, regardless of initial CEL level. For Cohort-2, the monthly rate was unchanged in the 0 initial CEL subgroup, but decreased 33% (95% confidence interval: 8%, 52%) from months 1-3 to months 4-6 in the other two subgroups. For the combined cohorts, a decreasing rate was observed in the 12 patients with >3 initial CELs and pre-study relapses.<br />Conclusions: The short-term trend of new CEL activity in placebo-treated SPMS patients may vary across cohorts.