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Treatment response scoring systems to assess long-term prognosis in self-injectable DMTs relapsing–remitting multiple sclerosis patients

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A Correction to this article was published on 20 November 2021

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Abstract

Background and objectives

Different treatment response scoring systems in treated MS patients exist. The objective was to assess the long-term predictive value of these systems in RRMS patients treated with self-injectable DMTs.

Methods

RRMS-treated patients underwent brain MRI before the onset of therapy and 12 months thereafter, and neurological assessments every 6 months. Clinical and demographic characteristics were collected at baseline. After the first year of treatment, several scoring systems [Rio score (RS), modified Rio score (MRS), MAGNIMS score (MS), and ROAD score (RoS)] were calculated. Cox-Regression and survival analyses were performed to identify scores predicting long-term disability.

Results

We included 319 RRMS patients. Survival analyses showed that patients with RS > 1 and RoS > 3 had a significant risk of reaching an EDSS of 4.0 and 6.0 The score with the best sensitivity (61%) was the RoS, while the MRS showed the best specificity (88%). The RS showed the best positive predictive value (42%) and the best accuracy (81%).

Conclusions

The combined measures integrated into different scores have an acceptable prognostic value for identifying patients with long-term disability.

Thus, these data reinforce the concept of early treatment optimization to minimize the risk of long-term disability.

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Author information

Authors and Affiliations

  1. Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Servicio de Neurologia/Neuroimmunolgia, Hospital Universitari Vall d’Hebron, Passeig Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Jordi Río, Mar Tintoré, Susana Otero-Romero, Manuel Comabella, Ángela Vidal-Jordana, Ingrid Galán, Luciana Midaglia, Breogán Rodriguez-Acevedo, Ana Zabalza, Joaquim Castilló, Georgina Arrambide, Carlos Nos, Álvaro Cobo, Carmen Tur, Jaume Sastre-Garriga & Xavier Montalban

  2. Sección de Neuroradiología, Servicio de Radiologia, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

    Àlex Rovira & Cristina Auger

  3. Department of Neurosciences, San Camillo-Forlanini Hospital, Rome, Italy

    Claudio Gasperini & Luca Prosperini

Authors
  1. Jordi Río
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  2. Àlex Rovira
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  3. Claudio Gasperini
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  4. Mar Tintoré
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  5. Luca Prosperini
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  6. Susana Otero-Romero
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  7. Manuel Comabella
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  8. Ángela Vidal-Jordana
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  9. Ingrid Galán
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  10. Luciana Midaglia
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  11. Breogán Rodriguez-Acevedo
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  12. Ana Zabalza
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  13. Joaquim Castilló
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  14. Georgina Arrambide
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  15. Carlos Nos
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  16. Álvaro Cobo
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  17. Carmen Tur
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  18. Cristina Auger
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  19. Jaume Sastre-Garriga
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  20. Xavier Montalban
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Corresponding author

Correspondence to Jordi Río.

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Conflicts of interest

J Río has received speaking honoraria and personal compensation for participating on Advisory Boards from Almirall, Bayer-Schering Healthcare, Biogen-Idec, Genzyme, Merck- Serono, Novartis, Teva, and Sanofi-Aventis. A Rovira serves on scientific advisory boards for Novartis, Sanofi-Genzyme, SyntheticMR, Biogen and OLEA Medical, and has received speaker honoraria from Bayer, Sanofi-Genzyme, Merck-Serono, Teva Pharmaceutical Industries Ltd, Novartis, Roche and Biogen. C Gasperini has received fee as speaker or advisory board by Merck, Bayer, Biogen, Novartis, Teva, Genzyme. M Tintore has received compensation for consulting services and speaking honoraria from Almirall, Bayer Schering Pharma, Biogen-Idec, Genzyme, Merck-Serono, Novartis, Roche, Sanofi-Aventis, Viela Bio and Teva Pharmaceuticals. MT is co-editor of Multiple Sclerosis Journal- ETC. L Prosperini has received fee as speaker or advisory board by Merck, Bayer, Biogen, Novartis, Teva, Genzyme. S Otero-Romero has received speaking and consulting honoraria from Genzyme, Biogen-Idec, Novartis, Roche, Excemed and Merk; and research support from Novartis. M Comabella has received compensation for consulting services and speaking honoraria from Bayer Schering Pharma, Merk Serono, Biogen-Idec, Teva Pharmaceuticals, Sanofi-Aventis, and Novartis. C Nos has received compensation as steering committee member of clinical trials from Hoffmann-La Roche, and funding for registration in scientific meetings from Novartis. A Vidal-Jordana receives support for contracts Juan Rodes (JR16/00024) from Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III, Spain; and has received speaking honoraria and travel expenses from Novartis, Roche, Teva, Biogen and Sanofi-Genzyme. C Tur is currently being funded by a Junior Leader La Caixa Fellowship. The project that gave rise to these results received the support of a fellowship from “la Caixa” Foundation (ID 100010434). The fellowship code is LCF/BQ/PI20/11760008. She has also received the 2021 Merck’s Award for the Investigation in Multiple Sclerosis (Ayudas para la Investigación en Esclerosis Múltiple, 2021), awarded by the Merck Foundation. In 2015, she received an ECTRIMS Post-doctoral Research Fellowship and has received funding from the UK MS Society. She has also received honoraria and support for traveling from Merck Serono, Sanofi, Roche, TEVA Pharmaceuticals, Novartis, Biogen, Bayer and Ismar Healthcare. G. Arrambide has received compensation for consulting services or participation in advisory boards from Sanofi and Merck; research support from Novartis; travel expenses for scientific meetings from Novartis, Roche, and ECTRIMS; and speaking honoraria from Stendhal, Sanofi, Merck. G. Arrambide is a member of the executive committee of the International Women in Multiple Sclerosis (iWiMS) network. A. Cobo-Calvo has received grant from Instituto de Salud Carlos III, Spain; JR19/00007. Breogán Rodríguez-Acevedo has received honoraria for consulting services from Wellspect. C Auger has received speaking honoraria from Novartis, Biogen and Stendhal. J Sastre-Garriga has received compensation for participating on Advisory Boards, speaking honoraria and travel expenses for scientific meetings, consulting services or research support from Celgene, Novartis, Biogen, Teva, Merck, Almirall, and Genzyme. X Montalban has received speaking honoraria and travel expenses for participation inscientific meetings, has been a steering committee member of clinical trials or participated in advisory boards of clinical trials in the past with Actelion, Amirall, Bayer, Biogen, Celgene, Genzyme, Hoffmann-La Roche, Novartis, Oryzon Genomics, Sanofi-Genzyme, and Teva Pharmaceutical. L Midaglia, I Galán, J Castilló, and A Zabalza report no disclosures.

Ethical standard statement

The local ethical committee approved the study, and all patients provided their informed consent.

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Río, J., Rovira, À., Gasperini, C. et al. Treatment response scoring systems to assess long-term prognosis in self-injectable DMTs relapsing–remitting multiple sclerosis patients. J Neurol 269, 452–459 (2022). https://doi.org/10.1007/s00415-021-10823-z

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  • DOI: https://doi.org/10.1007/s00415-021-10823-z

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