Abstract
We evaluated 190 patients in the placebo group of the CHAMPS trial in order to assess factors associated with short-term clinical and brain magnetic resonance imaging (MRI) outcomes in patients with a first clinical demyelinating event involving the optic nerve, spinal cord, or brainstem/cerebellum, and subclinical demyelination on brain MRI. The two study outcomes were 1) development of clinically definite multiple sclerosis (CDMS) and 2) development of CDMS or two or more new or enlarging brain MRI T2 lesions. The presence of godolinium (Gd)-enhancing lesions on the baseline scan was the only MRI characteristic associated with a higher risk of both the clinical and combined outcomes (p=0.003 and <0.001, respectively). The only demographic or clinical characteristic associated with an increased risk of these outcomes was younger age (p<0.001 for both outcomes). The lowest risk subgroups we could define had a 30% risk of CDMS and a 65% risk of the combined clinical/MRI outcome. Our results indicate that all patients presenting with a first demyelinating event who also have brain MRI evidence of subclinical demyelination have at least a moderate risk of short-term disease activity. This finding provides support for initiating disease-modifying therapy at the time of the first demyelinating event in patients meeting the CHAMPS enrollment criteria.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 405-409 |
| Number of pages | 5 |
| Journal | Multiple Sclerosis |
| Volume | 8 |
| Issue number | 5 |
| DOIs | |
| State | Published - 2002 |
| Externally published | Yes |
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Keywords
- Brain MRI
- Multiple sclerosis
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
Cite this
Predictors of short-term disease activity following a first clinical demyelinating event : Analysis of the CHAMPS placebo group. / O'Connor, P.; Fleming, P.; Gray, T.; Jacobs, L.; Miller, C.; Munschauer, F.; Kinkel, R. P.; Bolibrush, D.; Cohen, J.; Freedman, M.; Webb, U.; Rabinowicz, H.; Metz, L. M.; Patry, D.; Yeung, M.; Peters, S.; Hashimoto, S.; Morrison, W.; Oger, J.; Panitch, H.; Costello, K.; Bever, C.; Stuart, W.; Court, D.; Stuart, D.; Tornatore, C.; Bartlett, D.; Richert, J.; Duquette, P.; Dubois, R.; Bernier, G.; Scott, T.; Pappert, L.; Brillman, J.; Felton, W.; Anderson, T.; Astruc, J.; Rose, J.; Kline, J.; Burns, J.; Murray, T.; Weldon, P.; Bhan, V.; Maxner, C. E.; Wall, M.; Vining, L.; Grabowski, T.; Apatoff, B.; Orapello, C.; Friedman, J.; Galetta, S.; Pfohl, D.; Liu, G.; Rice, G.; Bental, T.; Mandalfino, P.; Eggenberger, E.; Snider, D.; Kaufman, D.; Guarnaccia, J.; Shepard, M.; Goldstein, J.; Reiss, M.; Carter, E.; Glista, G.; Rolak, L.; Scheller, L.; Jacobson, D.; Warner, J.; Goodman, A.; Petrie, M.; Mattson, D.; Karlin, K.; Wallin, A.; Stefoski, D.; Brod, S.; Cerretta, E.; Wolinsky, J.; Arnold, D.; Arnoutelis, R.; Durcan, L.; Kupersmith, M.; Cappolino, L.; Herbert, J.; Rosenberg, J.; McHugh, D.; Blumenfeld, A.; Smith, C.; Kuder, D.; Hamilton, S.; Thurston, S.; McGee, J.; O'Bannon, J.; Kaufman, M.; Butler, M.; Putnam, S.; Rammohan, Kottil W; Siffort, A.; Lynn, J.; Selhorst, J.; Holzemer, E.; Hayat, G.; Tselis, A.; Coon, C.; Lisak, R.; Wray, S.; Sexton, P.; Lehrich, J.; Cook, S.; Jotkowitz, A.; Bansil, S.; Newman, N.; Brown, J.; Pennell, P.; Gilmore, J.; Carter, J.; Buckner, J.; Caselli, R.; Kerson, L.; Camasso, M.; Donneief, G.; Cooper, J.; Richardson, B.; Kung, C.; Goodwin, J.; Johnson, T.; Gulati, A.; Hedges, T.; Yardley, C.; Tran, T.; Brown, W.; Ehrenberg, B.; Horowitz, S.; Bonnett, A.; Burger, R.; Javerbaum, J.; Griffin, C.; Whaley, R. J.; Jeffery, D.; Jackson, S. E.; Bastings, E.; Kasper, L.; Ryan, K.; Bernat, J.; Mass, M.; Cooper Hanel, S.; Bourdette, D.; Guy, John; Wilson, M.; Greer, M.; Lucchinetti, C.; Botten, M.; Noseworthy, J.; Walker, A.; Muntz, B.; Tyor, W.; Simon, J.; Meyer, M.; Leek, R.; Gustafson, C.; Singel, D.; Quandt, B.; Miller, D. E.; Coombs, B.; Cajade-Law, A.; Lajaunie, M.; Escott, E.; Miller, A.; Vollmer, T.; Brownscheidle, C.; Murray, T. J.; Antel, J.; Myers, L.; Birnbaum, G.; Reingold, S.; Burde, R.; Sibley, W.; Ware, J.; Blanchard, N.; Lloyd, K.; Park, H.; Sandrock, A.; Simonian, N.; Slasor, P.; Votruba, F.; White, K.; Beck, R. W.; Chandler, D. L.; Cole, S.
In: Multiple Sclerosis, Vol. 8, No. 5, 2002, p. 405-409.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predictors of short-term disease activity following a first clinical demyelinating event
T2 - Analysis of the CHAMPS placebo group
AU - O'Connor, P.
AU - Fleming, P.
AU - Gray, T.
AU - Jacobs, L.
AU - Miller, C.
AU - Munschauer, F.
AU - Kinkel, R. P.
AU - Bolibrush, D.
AU - Cohen, J.
AU - Freedman, M.
AU - Webb, U.
AU - Rabinowicz, H.
AU - Metz, L. M.
AU - Patry, D.
AU - Yeung, M.
AU - Peters, S.
AU - Hashimoto, S.
AU - Morrison, W.
AU - Oger, J.
AU - Panitch, H.
AU - Costello, K.
AU - Bever, C.
AU - Stuart, W.
AU - Court, D.
AU - Stuart, D.
AU - Tornatore, C.
AU - Bartlett, D.
AU - Richert, J.
AU - Duquette, P.
AU - Dubois, R.
AU - Bernier, G.
AU - Scott, T.
AU - Pappert, L.
AU - Brillman, J.
AU - Felton, W.
AU - Anderson, T.
AU - Astruc, J.
AU - Rose, J.
AU - Kline, J.
AU - Burns, J.
AU - Murray, T.
AU - Weldon, P.
AU - Bhan, V.
AU - Maxner, C. E.
AU - Wall, M.
AU - Vining, L.
AU - Grabowski, T.
AU - Apatoff, B.
AU - Orapello, C.
AU - Friedman, J.
AU - Galetta, S.
AU - Pfohl, D.
AU - Liu, G.
AU - Rice, G.
AU - Bental, T.
AU - Mandalfino, P.
AU - Eggenberger, E.
AU - Snider, D.
AU - Kaufman, D.
AU - Guarnaccia, J.
AU - Shepard, M.
AU - Goldstein, J.
AU - Reiss, M.
AU - Carter, E.
AU - Glista, G.
AU - Rolak, L.
AU - Scheller, L.
AU - Jacobson, D.
AU - Warner, J.
AU - Goodman, A.
AU - Petrie, M.
AU - Mattson, D.
AU - Karlin, K.
AU - Wallin, A.
AU - Stefoski, D.
AU - Brod, S.
AU - Cerretta, E.
AU - Wolinsky, J.
AU - Arnold, D.
AU - Arnoutelis, R.
AU - Durcan, L.
AU - Kupersmith, M.
AU - Cappolino, L.
AU - Herbert, J.
AU - Rosenberg, J.
AU - McHugh, D.
AU - Blumenfeld, A.
AU - Smith, C.
AU - Kuder, D.
AU - Hamilton, S.
AU - Thurston, S.
AU - McGee, J.
AU - O'Bannon, J.
AU - Kaufman, M.
AU - Butler, M.
AU - Putnam, S.
AU - Rammohan, Kottil W
AU - Siffort, A.
AU - Lynn, J.
AU - Selhorst, J.
AU - Holzemer, E.
AU - Hayat, G.
AU - Tselis, A.
AU - Coon, C.
AU - Lisak, R.
AU - Wray, S.
AU - Sexton, P.
AU - Lehrich, J.
AU - Cook, S.
AU - Jotkowitz, A.
AU - Bansil, S.
AU - Newman, N.
AU - Brown, J.
AU - Pennell, P.
AU - Gilmore, J.
AU - Carter, J.
AU - Buckner, J.
AU - Caselli, R.
AU - Kerson, L.
AU - Camasso, M.
AU - Donneief, G.
AU - Cooper, J.
AU - Richardson, B.
AU - Kung, C.
AU - Goodwin, J.
AU - Johnson, T.
AU - Gulati, A.
AU - Hedges, T.
AU - Yardley, C.
AU - Tran, T.
AU - Brown, W.
AU - Ehrenberg, B.
AU - Horowitz, S.
AU - Bonnett, A.
AU - Burger, R.
AU - Javerbaum, J.
AU - Griffin, C.
AU - Whaley, R. J.
AU - Jeffery, D.
AU - Jackson, S. E.
AU - Bastings, E.
AU - Kasper, L.
AU - Ryan, K.
AU - Bernat, J.
AU - Mass, M.
AU - Cooper Hanel, S.
AU - Bourdette, D.
AU - Guy, John
AU - Wilson, M.
AU - Greer, M.
AU - Lucchinetti, C.
AU - Botten, M.
AU - Noseworthy, J.
AU - Walker, A.
AU - Muntz, B.
AU - Tyor, W.
AU - Simon, J.
AU - Meyer, M.
AU - Leek, R.
AU - Gustafson, C.
AU - Singel, D.
AU - Quandt, B.
AU - Miller, D. E.
AU - Coombs, B.
AU - Cajade-Law, A.
AU - Lajaunie, M.
AU - Escott, E.
AU - Miller, A.
AU - Vollmer, T.
AU - Brownscheidle, C.
AU - Murray, T. J.
AU - Antel, J.
AU - Myers, L.
AU - Birnbaum, G.
AU - Reingold, S.
AU - Burde, R.
AU - Sibley, W.
AU - Ware, J.
AU - Blanchard, N.
AU - Lloyd, K.
AU - Park, H.
AU - Sandrock, A.
AU - Simonian, N.
AU - Slasor, P.
AU - Votruba, F.
AU - White, K.
AU - Beck, R. W.
AU - Chandler, D. L.
AU - Cole, S.
PY - 2002
Y1 - 2002
N2 - We evaluated 190 patients in the placebo group of the CHAMPS trial in order to assess factors associated with short-term clinical and brain magnetic resonance imaging (MRI) outcomes in patients with a first clinical demyelinating event involving the optic nerve, spinal cord, or brainstem/cerebellum, and subclinical demyelination on brain MRI. The two study outcomes were 1) development of clinically definite multiple sclerosis (CDMS) and 2) development of CDMS or two or more new or enlarging brain MRI T2 lesions. The presence of godolinium (Gd)-enhancing lesions on the baseline scan was the only MRI characteristic associated with a higher risk of both the clinical and combined outcomes (p=0.003 and <0.001, respectively). The only demographic or clinical characteristic associated with an increased risk of these outcomes was younger age (p<0.001 for both outcomes). The lowest risk subgroups we could define had a 30% risk of CDMS and a 65% risk of the combined clinical/MRI outcome. Our results indicate that all patients presenting with a first demyelinating event who also have brain MRI evidence of subclinical demyelination have at least a moderate risk of short-term disease activity. This finding provides support for initiating disease-modifying therapy at the time of the first demyelinating event in patients meeting the CHAMPS enrollment criteria.
AB - We evaluated 190 patients in the placebo group of the CHAMPS trial in order to assess factors associated with short-term clinical and brain magnetic resonance imaging (MRI) outcomes in patients with a first clinical demyelinating event involving the optic nerve, spinal cord, or brainstem/cerebellum, and subclinical demyelination on brain MRI. The two study outcomes were 1) development of clinically definite multiple sclerosis (CDMS) and 2) development of CDMS or two or more new or enlarging brain MRI T2 lesions. The presence of godolinium (Gd)-enhancing lesions on the baseline scan was the only MRI characteristic associated with a higher risk of both the clinical and combined outcomes (p=0.003 and <0.001, respectively). The only demographic or clinical characteristic associated with an increased risk of these outcomes was younger age (p<0.001 for both outcomes). The lowest risk subgroups we could define had a 30% risk of CDMS and a 65% risk of the combined clinical/MRI outcome. Our results indicate that all patients presenting with a first demyelinating event who also have brain MRI evidence of subclinical demyelination have at least a moderate risk of short-term disease activity. This finding provides support for initiating disease-modifying therapy at the time of the first demyelinating event in patients meeting the CHAMPS enrollment criteria.
KW - Brain MRI
KW - Multiple sclerosis
UR - http://www.scopus.com/inward/record.url?scp=18544375281&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=18544375281&partnerID=8YFLogxK
U2 - 10.1191/1352458502ms825oa
DO - 10.1191/1352458502ms825oa
M3 - Article
C2 - 12356207
AN - SCOPUS:18544375281
VL - 8
SP - 405
EP - 409
JO - Multiple Sclerosis
JF - Multiple Sclerosis
SN - 1352-4585
IS - 5
ER -