…n the full cohort (active and inactive patients) receiving siponimod (PBVC -0.71%) compared to those with active disease (-0.86%). While this suggests that inflammatory activity is an important contributor to brain atrophy, it may also indicate that progressive tissue loss is not entirely dependent on inflammation and may respond to therapy. Moreover, a separate analysis found that a significant treatment effect on the EDSS Motor Integration subsc…

…mod or natalizumab. With these regimens, 58.9% of patients remained relapse-free and 51.9% had no three-month CDP at five-year follow-up. The relative merits of escalation versus de-escalation after high-efficacy treatment were also examined at the Cleveland Clinic (Hersh et al. ECTRIMS 2019; abstract P972). A cohort of 556 patients discontinued natalizumab and were switched either to an oral DMT (DMF or fingolimod) or less commonly to a MAb (ocre…

…g continuous DMF 240 mg BID for 10 years reported that 51% remained relapse-free (Gold et al. ECTRIMS 2019; abstract P1397). The median time to first relapse was 9.7 years. A total of 79% had minimal disability (EDSS score < 3.5) at 10 years, with 64% demonstrating no confirmed disability progression from baseline. The incidence of serious infections was 2% in Year 1 and < 1% every year thereafter. Back to top Declining effect of treatment An MSBa…

…r. An Italian study reported that MEDA was not predictive of disability outcomes (3-month CDP, progression to SPMS, EDSS score 4.0 or 6.0) at seven years (Tsantes et al. ECTRIMS 2019; abstract P1050). In contrast, NEDA status was associated with a significantly lower risk of 3-month CDP at seven years compared to MEDA (odds ratio 0.3). Back to top RIS – Predictors of CIS/MS A retrospective analysis of 451 patients with radiologically isolated synd…