Abstract
Predicting treatment failure and switching effective treatment immediately in patients with multiple sclerosis (MS) is important. We aimed to evaluate the usefulness of Modified Rio score (MRS) in predicting treatment failure in MS patients. This is a retrospective study, which was conducted in two University Hospital. 129 MS patients treated with İnterferon or glatiramer-acetate from 2 clinical sites, were retrospectively selected. MRS was calculated after the first year of therapy. Treatment failure was defined as the presence of a 1 point increase in EDSS, 2 clinical attacks, 1 clinical attack and progression, 1 clinical attack and new lesion on MRI except associated with an attack, or new lesion in 2 different MRI taken at least 3 months apart. The sensitivity, specificity, positive and negative predictive values of the MRS in predicting treatment failure were determined. 71 (55%) patients with score ‘0’, 41 (31.8%) patients with score ‘1’, 11 (8.5%) patients with score ‘2’, 6 (4.7%) patients with score ‘3’ were detected. 14 patients needed treatment switching during the first three years of the treatment. Sensitivity was 57%, specificity was 92%, positive predictive value was 95%, negative predictive value was 47% and accuracy was 89%. Modified Rio score (MRS) was found to be effective in determining the treatment failure as mentioned before. This study will be useful for clinicians who evaluate the treatment failure like us, and this study revealed that the MRS may also help predict treatment failure.
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07 March 2022
A Correction to this paper has been published: https://doi.org/10.1007/s13760-022-01897-1
References
Annibali V et al (2006) Multiple sclerosis: Pharmacogenomics and personalised drug treatment. Neurol Sci 27(SUPPL. 5):347–349. https://doi.org/10.1007/s10072-006-0691-y
Karussis D (2014) The diagnosis of multiple sclerosis and the various related demyelinating syndromes a critical review. J Autoimmune 48–9:134–142
Caniglia-Tenaglia M et al (2018) Multiple sclerosis in the Republic of San Marino, Italian peninsula: an incidence and prevalence study from a high-risk area. Neurol Sci 39(7):1231–1236. https://doi.org/10.1007/s10072-018-3402-6
Çelik Y, Birgili O, Yılmaz H, Kıyat A, Saip S, Siva A, Güldiken B, Ozkan H, Kuscu D, Sutlas N, Agaoglu J, Utku U (2011) Prevalence of multiple sclerosis in the metropolitan area of Edirne city, Turkey. J Balkan Med 28:193–196
Akdemir N, Terzi M, Arslan N, Onar M (2017) Prevalence of multiple sclerosis in the middle black sea region of turkey and demographic characteristics of patients. J Neuropsychiatry 54(1):11–14
Turkboru U, Alp R, Sur H, Gul L (2006) Prevalence of multiple sclerosis: door to door survey in Maltepe, Istanbul, Turkey. Neuroepidemology 27:17–21
Kantarci OH (2019) Phases and phenotypes of multiple sclerosis. Contin Lifelong Learn Neurol 25(3):636–654. https://doi.org/10.1212/CON.0000000000000737
Confavreux C, Vukusic S, Moreau T, Adeleine P (2000) Relapses and progression of disability in multiple sclerosis. N Engl J Med. https://doi.org/10.1056/NEJM200011163432001
Montalban X et al (2009) Primary progressive multiple sclerosis diagnostic criteria: a reappraisal. Multiple Sclerosis. https://doi.org/10.1177/1352458509348422
Rotstein D, Montalban X (2019) Reaching an evidence-based prognosis for personalized treatment of multiple sclerosis. Nat Rev Neurol 15(5):287–300. https://doi.org/10.1038/s41582-019-0170-8
Gasperini C et al (2019) Unraveling treatment response in multiple sclerosis: a clinical and MRI challenge. Neurology 92(4):180–192. https://doi.org/10.1212/WNL.0000000000006810
Río J et al (2009) Measures in the first year of therapy predict the response to interferon β in MS. Multiple Scler 15(7):848–853. https://doi.org/10.1177/1352458509104591
Sormani MP et al (2013) Scoring treatment response in patients with relapsing multiple sclerosis. Multiple Scler J 19(5):605–612. https://doi.org/10.1177/1352458512460605
Romeo M et al (2015) Validation of 1-year predictive score of long-term response to interferon-β in everyday clinical practice multiple sclerosis patients. Eur J Neurol 22(6):973–980. https://doi.org/10.1111/ene.12695
Sormani MP et al (2016) Assessing response to interferon-β in a multicenter dataset of patients with MS. Neurology 87(2):134–140. https://doi.org/10.1212/WNL.0000000000002830
Drulovic J et al (2019) Long-term disability outcomes in relapsing-remitting multiple sclerosis: a 10-year follow-up study. Neurol Sci 40(8):1627–1636. https://doi.org/10.1007/s10072-019-03878-4
Hentati E, Ben Sassi S, Nabli F, Mabrouk T, Zouari M, Hentati F (2018) Disability progression in multiple sclerosis: a Tunisian prospective cohort study. Neurol Sci 39(5):879–884. https://doi.org/10.1007/s10072-018-3295-4
Río J et al (2018) Disability progression markers over 6–12 years in interferon-β-treated multiple sclerosis patients. Multiple Scler J 24(3):322–330. https://doi.org/10.1177/1352458517698052
Sormani MP, Bruzzi P (2013) MRI lesions as a surrogate for relapses in multiple sclerosis: a metaanalysis of randomised trials. Lancet Neurol 12(7):669–676. https://doi.org/10.1016/S1474-4422(13)70103-0
Hyun JW et al (2015) Utility of the Rio score and modified Rio score in Korean patients with multiple sclerosis. PLoS ONE 10(5):1–9. https://doi.org/10.1371/journal.pone.0129243
Río J et al (2006) Defining the response to interferon-β in relapsing-remitting multiple sclerosis patients. Ann Neurol 59(2):344–352. https://doi.org/10.1002/ana.20740
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Tutuncu, M., Altintas, A., Dogan, B.V. et al. The use of Modified Rio score for determining treatment failure in patients with multiple sclerosis: retrospective descriptive case series study. Acta Neurol Belg 121, 1693–1698 (2021). https://doi.org/10.1007/s13760-020-01476-2
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DOI: https://doi.org/10.1007/s13760-020-01476-2