Predictors of short-term disease activity following a first clinical demyelinating event: Analysis of the CHAMPS placebo group

P. O'Connor, P. Fleming, T. Gray, L. Jacobs, C. Miller, F. Munschauer, R. P. Kinkel, D. Bolibrush, J. Cohen, M. Freedman, U. Webb, H. Rabinowicz, L. M. Metz, D. Patry, M. Yeung, S. Peters, S. Hashimoto, W. Morrison, J. Oger, H. PanitchK. Costello, C. Bever, W. Stuart, D. Court, D. Stuart, C. Tornatore, D. Bartlett, J. Richert, P. Duquette, R. Dubois, G. Bernier, T. Scott, L. Pappert, J. Brillman, W. Felton, T. Anderson, J. Astruc, J. Rose, J. Kline, J. Burns, T. Murray, P. Weldon, V. Bhan, C. E. Maxner, M. Wall, L. Vining, T. Grabowski, B. Apatoff, C. Orapello, J. Friedman, S. Galetta, D. Pfohl, G. Liu, G. Rice, T. Bental, P. Mandalfino, E. Eggenberger, D. Snider, D. Kaufman, J. Guarnaccia, M. Shepard, J. Goldstein, M. Reiss, E. Carter, G. Glista, L. Rolak, L. Scheller, D. Jacobson, J. Warner, A. Goodman, M. Petrie, D. Mattson, K. Karlin, A. Wallin, D. Stefoski, S. Brod, E. Cerretta, J. Wolinsky, D. Arnold, R. Arnoutelis, L. Durcan, M. Kupersmith, L. Cappolino, J. Herbert, J. Rosenberg, D. McHugh, A. Blumenfeld, C. Smith, D. Kuder, S. Hamilton, S. Thurston, J. McGee, J. O'Bannon, M. Kaufman, M. Butler, S. Putnam, Kottil W Rammohan, A. Siffort, J. Lynn, J. Selhorst, E. Holzemer, G. Hayat, A. Tselis, C. Coon, R. Lisak, S. Wray, P. Sexton, J. Lehrich, S. Cook, A. Jotkowitz, S. Bansil, N. Newman, J. Brown, P. Pennell, J. Gilmore, J. Carter, J. Buckner, R. Caselli, L. Kerson, M. Camasso, G. Donneief, J. Cooper, B. Richardson, C. Kung, J. Goodwin, T. Johnson, A. Gulati, T. Hedges, C. Yardley, T. Tran, W. Brown, B. Ehrenberg, S. Horowitz, A. Bonnett, R. Burger, J. Javerbaum, C. Griffin, R. J. Whaley, D. Jeffery, S. E. Jackson, E. Bastings, L. Kasper, K. Ryan, J. Bernat, M. Mass, S. Cooper Hanel, D. Bourdette, John Guy, M. Wilson, M. Greer, C. Lucchinetti, M. Botten, J. Noseworthy, A. Walker, B. Muntz, W. Tyor, J. Simon, M. Meyer, R. Leek, C. Gustafson, D. Singel, B. Quandt, D. E. Miller, B. Coombs, A. Cajade-Law, M. Lajaunie, E. Escott, A. Miller, T. Vollmer, C. Brownscheidle, T. J. Murray, J. Antel, L. Myers, G. Birnbaum, S. Reingold, R. Burde, W. Sibley, J. Ware, N. Blanchard, K. Lloyd, H. Park, A. Sandrock, N. Simonian, P. Slasor, F. Votruba, K. White, R. W. Beck, D. L. Chandler, S. Cole

Research output: Contribution to journalArticle

11 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)405-409
Number of pages5
JournalMultiple Sclerosis
Volume8
Issue number5
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Placebos
Magnetic Resonance Imaging
Multiple Sclerosis
Brain
Demyelinating Diseases
Optic Nerve
Cerebellum
Brain Stem
Spinal Cord
Demography
Outcome Assessment (Health Care)
Therapeutics

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 journalArticle

O'Connor, P, Fleming, P, Gray, T, Jacobs, L, Miller, C, Munschauer, F, Kinkel, RP, Bolibrush, D, Cohen, J, Freedman, M, Webb, U, Rabinowicz, H, Metz, LM, 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, CE, 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, KW, 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, RJ, Jeffery, D, Jackson, SE, Bastings, E, Kasper, L, Ryan, K, Bernat, J, Mass, M, Cooper Hanel, S, Bourdette, D, Guy, J, 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, DE, Coombs, B, Cajade-Law, A, Lajaunie, M, Escott, E, Miller, A, Vollmer, T, Brownscheidle, C, Murray, TJ, 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, RW, Chandler, DL & Cole, S 2002, 'Predictors of short-term disease activity following a first clinical demyelinating event: Analysis of the CHAMPS placebo group', Multiple Sclerosis, vol. 8, no. 5, pp. 405-409. https://doi.org/10.1191/1352458502ms825oa
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. / Predictors of short-term disease activity following a first clinical demyelinating event : Analysis of the CHAMPS placebo group. In: Multiple Sclerosis. 2002 ; Vol. 8, No. 5. pp. 405-409.
@article{09e107d38759448f9174b49998dcaece,
title = "Predictors of short-term disease activity following a first clinical demyelinating event: Analysis of the CHAMPS placebo group",
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.",
keywords = "Brain MRI, Multiple sclerosis",
author = "P. O'Connor and P. Fleming and T. Gray and L. Jacobs and C. Miller and F. Munschauer and Kinkel, {R. P.} and D. Bolibrush and J. Cohen and M. Freedman and U. Webb and H. Rabinowicz and Metz, {L. M.} and D. Patry and M. Yeung and S. Peters and S. Hashimoto and W. Morrison and J. Oger and H. Panitch and K. Costello and C. Bever and W. Stuart and D. Court and D. Stuart and C. Tornatore and D. Bartlett and J. Richert and P. Duquette and R. Dubois and G. Bernier and T. Scott and L. Pappert and J. Brillman and W. Felton and T. Anderson and J. Astruc and J. Rose and J. Kline and J. Burns and T. Murray and P. Weldon and V. Bhan and Maxner, {C. E.} and M. Wall and L. Vining and T. Grabowski and B. Apatoff and C. Orapello and J. Friedman and S. Galetta and D. Pfohl and G. Liu and G. Rice and T. Bental and P. Mandalfino and E. Eggenberger and D. Snider and D. Kaufman and J. Guarnaccia and M. Shepard and J. Goldstein and M. Reiss and E. Carter and G. Glista and L. Rolak and L. Scheller and D. Jacobson and J. Warner and A. Goodman and M. Petrie and D. Mattson and K. Karlin and A. Wallin and D. Stefoski and S. Brod and E. Cerretta and J. Wolinsky and D. Arnold and R. Arnoutelis and L. Durcan and M. Kupersmith and L. Cappolino and J. Herbert and J. Rosenberg and D. McHugh and A. Blumenfeld and C. Smith and D. Kuder and S. Hamilton and S. Thurston and J. McGee and J. O'Bannon and M. Kaufman and M. Butler and S. Putnam and Rammohan, {Kottil W} and A. Siffort and J. Lynn and J. Selhorst and E. Holzemer and G. Hayat and A. Tselis and C. Coon and R. Lisak and S. Wray and P. Sexton and J. Lehrich and S. Cook and A. Jotkowitz and S. Bansil and N. Newman and J. Brown and P. Pennell and J. Gilmore and J. Carter and J. Buckner and R. Caselli and L. Kerson and M. Camasso and G. Donneief and J. Cooper and B. Richardson and C. Kung and J. Goodwin and T. Johnson and A. Gulati and T. Hedges and C. Yardley and T. Tran and W. Brown and B. Ehrenberg and S. Horowitz and A. Bonnett and R. Burger and J. Javerbaum and C. Griffin and Whaley, {R. J.} and D. Jeffery and Jackson, {S. E.} and E. Bastings and L. Kasper and K. Ryan and J. Bernat and M. Mass and {Cooper Hanel}, S. and D. Bourdette and John Guy and M. Wilson and M. Greer and C. Lucchinetti and M. Botten and J. Noseworthy and A. Walker and B. Muntz and W. Tyor and J. Simon and M. Meyer and R. Leek and C. Gustafson and D. Singel and B. Quandt and Miller, {D. E.} and B. Coombs and A. Cajade-Law and M. Lajaunie and E. Escott and A. Miller and T. Vollmer and C. Brownscheidle and Murray, {T. J.} and J. Antel and L. Myers and G. Birnbaum and S. Reingold and R. Burde and W. Sibley and J. Ware and N. Blanchard and K. Lloyd and H. Park and A. Sandrock and N. Simonian and P. Slasor and F. Votruba and K. White and Beck, {R. W.} and Chandler, {D. L.} and S. Cole",
year = "2002",
doi = "10.1191/1352458502ms825oa",
language = "English (US)",
volume = "8",
pages = "405--409",
journal = "Multiple Sclerosis",
issn = "1352-4585",
publisher = "SAGE Publications Ltd",
number = "5",

}

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 -