Better prognosis for OCB-negative patients


Highlights of the 29th Congress of the European Committee for Treatment and Research in MS (ECTRIMS), Copenhagen, DK, October 2-5, 2013 – MRI has largely eclipsed CSF analysis of oligoclonal bands (OCB) as the preferred paraclinical assessment to support a diagnosis of MS and there are conflicting reports on the prognostic significance of OCB results. Some studies have found that OCB-negativity is prognostic of a more favourable long-term outcome (Joseph et al. J Neurol Neurosurg Psychiatry 2009;80:292-296; Mandrioli et al. J Neurol 2008;255:1023-1031).

In contrast, a Canadian retrospective study of 451 MS patients reported that there was no association between OCB status and progression or relapse frequency (Siritho & Freedman. J Neurol Sci 2009;279:21-25). The clinical importance of OCBs was the focus of a recently published debate (Yes: Sandberg-Wollheim & Olsson. No: Tur & Montalban. Mult Scler 2013;19:714-718).

A new retrospective study analysed the OCB status of 474 MS patients for the period 2007-2012 (Sharipova et al. ECTRIMS 2013; abstract P246). Overall, 86.5% were OCB-positive and 13.5% were OCB-negative. There was no difference in patient age, gender, duration of MS or clinical presentation at diagnosis. However, there was a significant difference between the OCB-positive and OCB-negative groups with respect to age of MS onset (30.28 vs. 27.77 years). At 10-year follow-up, a higher proportion of OCB-positive patients had developed SPMS (26.6% vs. 8.0%; hazard ratio 2.4). OCB-positive patients also had a higher risk of progression to EDSS 6.0 at 10 years (26.7% vs. 8.0%).

Guest Reviewer: Dr. Paul S. Giacomini, Associate Director, MS Clinic, Montreal Neurological Hospital and Institute, Assistant Professor, Department of Neurology and Neurosurgery, McGill University, Montréal, Québec.


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