Multiple sclerosis (Houndmills, Basingstoke, England) · 2026
Impact of multiple sclerosis disease-modifying therapies on chronic lesion tissue expansion.
СтатьяНазвание и аннотация: Перевод в очереди
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Guilfoyle Daniel, Ward Kayla, Klistorner Samuel, Lizak Nathaniel, Beadnall Heidi N, Zivadinov Robert, Weinstock-Guttman Bianca, Roos Izanne, Butzkueven Helmut, van der Walt Anneke, Buzzard Katherine, Skibina Olga, Dwyer Mike G, Barnett Yael, Lui Elaine, Law Meng, Shieh Andy, Klistorner Alexander, Wang Chenyu, Kalincik Tomas, Barnett Michael
Аннотация
BACKGROUND: Chronic lesion tissue expansion (CLTE) reflects slow, concentric growth of established multiple sclerosis (MS) lesions and is linked to central brain atrophy and disability progression. Whether existing MS disease-modifying therapies (DMTs) differentially influence this aspect of progressive MS biology remains unclear.
OBJECTIVES: To compare the effect of current DMTs on CLTE in a multicentre, real-world MS cohort.
METHODS: We conducted a retrospective, observational study using linked clinical data from MSBase and the MSBase Imaging Repository. Data from patients aged ⩾18 years with ⩾3 longitudinal MRI scans, and 7 therapies with ⩾100 stable treatment epochs were included. Therapy effects on CLTE, new T2 lesions, and brain atrophy were assessed using epoch-based covariate-adjusted generalised estimating equation models, with fingolimod as a comparator.
RESULT: The cohort included 564 patients contributing 1648 stable treatment epochs. After adjustment for demographic, clinical, and imaging covariates, B-cell depleting therapy was the only DMT associated with significantly lower CLTE (β = -4.03, p = 0.017) relative to fingolimod. CLTE was independently associated with age, baseline lesion volume, and centre effects.
CONCLUSIONS: B-cell depletion is associated with reduced CLTE, a promising biomarker of progressive MS biology.
OBJECTIVES: To compare the effect of current DMTs on CLTE in a multicentre, real-world MS cohort.
METHODS: We conducted a retrospective, observational study using linked clinical data from MSBase and the MSBase Imaging Repository. Data from patients aged ⩾18 years with ⩾3 longitudinal MRI scans, and 7 therapies with ⩾100 stable treatment epochs were included. Therapy effects on CLTE, new T2 lesions, and brain atrophy were assessed using epoch-based covariate-adjusted generalised estimating equation models, with fingolimod as a comparator.
RESULT: The cohort included 564 patients contributing 1648 stable treatment epochs. After adjustment for demographic, clinical, and imaging covariates, B-cell depleting therapy was the only DMT associated with significantly lower CLTE (β = -4.03, p = 0.017) relative to fingolimod. CLTE was independently associated with age, baseline lesion volume, and centre effects.
CONCLUSIONS: B-cell depletion is associated with reduced CLTE, a promising biomarker of progressive MS biology.