October 14, 2010 (Gothenburg, Sweden) — Patients who develop relapsing-remitting multiple sclerosis later in life and who have less inflammation are more likely to respond to immunomodulating therapies, report researchers.
Presenting here at the 26th Congress of the European Committee for Treatment and Research in Multiple Sclerosis, investigators described demographic, clinical, and imaging predictors of response to first-line therapies.
The retrospective, single-center study included 1203 patients with multiple sclerosis. Patients were followed up every 3 months and underwent brain magnetic resonance imaging once a year.
The team, led by Giancarlo Comi, MD, from the Scientific Institute San Raffaele in Milan, Italy, then broke response rates down by type of immunomodulating therapy.
Patients taking once-a-week interferon beta had a similar response at 37%, and those taking multiweekly interferon beta had a rate of 34%. Patients taking glatiramer acetate faired better at 42%.
The investigators tested potential predictors of response using a multivariate logistic regression model. They found older age at disease onset and less inflammatory activity predicted response to therapy. However, the researchers caution, the relatively short duration of follow-up may limit the reliability of the finding over a longer period.
Patients who responded well to therapy at 1 year tended to continue to enjoy the benefits of treatment at 2 years. After a year, 68% of patients had a complete response, and this persisted until the end of the study.
Asked by Medscape Medical News to comment, Sidney Spector, MD, from the Veterans Affairs Medical in Phoenix, Arizona, said he would have expected that patients with less disease burden would respond better to treatment. "I'm not surprised patients with less inflammatory activity responded well, but I'm not sure I would have anticipated that age at onset would be a factor," he said. "I think that one could have gone either way, so this is interesting.
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