Modified Rio Score with Platform Therapy Predicts Treatment Success with Fingolimod and Natalizumab in Relapsing-Remitting Multiple Sclerosis Patients

Journal of Clinical Medicine

Radosław Zajdel¹  Sławomir Wawrzyniak²  Agnieszka Słowik³  Monika Marona³  Marcin Wnuk³  Waldemar Fryze⁴  Ewa Krzystanek⁵  Anna Jamroz-Wiśniewska⁶  Konrad Rejdak⁶  Dorota Koziarska⁷  Anna Karbicka⁸  Bożena Adamczyk⁹  Monika Adamczyk-Sowa⁹  Arkadiusz Stęposz^1,10  Anetta Lasek-Bal^1,10  Przemysław Puz^1,10  Sławomir Budrewicz^1,11  Anna Pokryszko-Dragan^1,11  Maja Patalong-Ogiewa^1,12  Marzena Furtak-Niczyporuk^1,13 

[1] Chair of Informatics in Business, University of Lodz, Rewolucji 1905 roku 37/39, 91-001 Lodz, Poland;Department of Neurology, 10th Military Research Hospital and Polyclinic, Powstancow Warszawy 5, 85-681 Bydgoszcz, Poland;Department of Neurology, Collegium Medicum, Jagiellonian University, Jakubowskiego 2, 30-688 Krakow, Poland;Department of Neurology, Copernicus Pl, M. Kopernik Hospital, Nowe Ogrody 1-6, 80-803 Gdansk, Poland;Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medykow 14, 40-752 Katowice, Poland;Department of Neurology, Medical University of Lublin, Jaczewskiego 8, 20-054 Lublin, Poland;Department of Neurology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland;Department of Neurology, Regional Hospital, Arkonska4, 71-455 Szczecin, Poland;Department of Neurology, School of Health Sciences in Zabrze, Medical University of Silesia in Katowice, 3-go Maja 13-15, 41-800 Zabrze, Poland;Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Ziolowa 45-47, 40-635 Katowice, Poland;Department of Neurology, Wroclaw Medical University, Borowska 213, 50-566 Wroclaw, Poland;Department of Neurorehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medykow 14, 40-752 Katowice, Poland;Department of Public Health, Medical University of Lublin, 20-954 Lublin, Poland;

关键词: relapsing-remitting type of multiple sclerosis;    no evidence of disease activity (NEDA);    modified Rio score (MRS);    natalizumab;    fingolimod;   

DOI  :  10.3390/jcm10091830

来源: DOAJ

【 摘 要 】

Background: Reliable markers of disease outcomes in multiple sclerosis (MS) would help to predict the response to treatment in patients treated with high efficacy drugs. No evidence of disease activity (NEDA) has become a treatment goal whereas the modified Rio score (MRS) predicts future suboptimal responders to treatment. The aim of our study was to identify factors that would predict poor response to treatment with natalizumab and fingolimod. Methods: In the multicenter prospective trial, 336 subjects were enrolled, initiating therapy with natalizumab (n = 135) or fingolimod (n = 201). Data on relapse rate, the expanded disability status scale, and MRI results were collected, and MRS was estimated. Results: NEDA-3 after the first year of therapy was 73.9% for natalizumab and 54.8% for fingolimod (p < 0.0001). Patients with MRS = 0 in the last year on platform therapy had the best NEDA-3 (71%) and patients with MRS = 3 had the worst NEDA-3 (41%) in the first year of treatment with the second-line therapy. Conclusion: We conclude that switching to the second-line therapy should occur earlier to enable better results for patients treated with natalizumab or fingolimod. The outcome on both drugs is better with better neurological conditions and lower MRS of the patient on the platform therapy.

【 授权许可】

Unknown