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Vrenken H, Battaglini M, de Vos ML, Nagtegaal GJ, Teixeira BCA, Seitzinger A, Jack D, Sormani MP, Uitdehaag BMJ, Versteeg A, Comi G, Kappos L, De Stefano N, Barkhof F. Temporal evolution of new T1-weighted hypo-intense lesions and central brain atrophy in patients with a first clinical demyelinating event treated with subcutaneous interferon β-1a. J Neurol 2023; 270:2271-2282. [PMID: 36723685 PMCID: PMC10025187 DOI: 10.1007/s00415-022-11554-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Evaluate the effect of subcutaneous interferon β-1a (sc IFN β-1a) versus placebo on the evolution of T1-weighted MRI lesions and central brain atrophy in in patients with a first clinical demyelinating event (FCDE). METHODS Post hoc analysis of baseline-to-24 month MRI data from patients with an FCDE who received sc IFN β-1a 44 μg once- (qw) or three-times-weekly (tiw), or placebo, in REFLEX. Patients were grouped according to treatment regimen or conversion to clinically definite MS (CDMS) status. The intensity of new lesions on unenhanced T1-weighted images was classified as T1 iso- or hypo-intense (black holes) and percentage ventricular volume change (PVVC) was assessed throughout the study. RESULTS In patients not converting to CDMS, sc IFN β-1a tiw or qw, versus placebo, reduced the overall number of new lesions (P < 0.001 and P = 0.005) and new T1 iso-intense lesions (P < 0.001 and P = 0.002) after 24 months; only sc IFN β-1a tiw was associated with fewer T1 hypo-intense lesions versus placebo (P < 0.001). PVVC findings in patients treated with sc IFN β-1a suggested pseudo-atrophy that was ~ fivefold greater versus placebo in the first year of treatment (placebo 1.11%; qw 4.28%; tiw 6.76%; P < 001); similar findings were apparent for non-converting patients. CONCLUSIONS In patients with an FCDE, treatment with sc IFN β-1a tiw for 24 months reduced the number of new lesions evolving into black holes.
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Affiliation(s)
- H Vrenken
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands.
| | - M Battaglini
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - M L de Vos
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - G J Nagtegaal
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - B C A Teixeira
- Department of Radiology, Federal University of Paraná, Curitiba, Paraná, Brazil
- Neuroradiology Department, Neurological Institute of Curitiba (INC/CETAC), Curitiba, Paraná, Brazil
| | - A Seitzinger
- Global Biostatistics, Merck Healthcare KGaA, Darmstadt, Germany
| | - D Jack
- Global Medical Affairs, Merck Serono Ltd, (an affiliate of Merck KGaA), Feltham, UK
| | - M P Sormani
- Department of Health Sciences, University of Genoa and Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - B M J Uitdehaag
- Department of Neurology, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - A Versteeg
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Biomedical Imaging Group Rotterdam, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - G Comi
- Università Vita-Salute San Raffaele, Casa di Cura Privata del Policlinico, Milan, Italy
| | - L Kappos
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) and Neurology Departments of Head, Spine and Neuromedicine, Biomedical Engineering and Clinical Research, University Hospital, University of Basel, Basel, Switzerland
| | - N De Stefano
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - F Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
- UCL Institutes of Neurology and Healthcare Engineering, London, UK
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