Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study
Language English Country Great Britain, England Media print-electronic
Document type Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't
PubMed
25680984
DOI
10.1177/1352458514568827
PII: 1352458514568827
Knihovny.cz E-resources
- Keywords
- Clinically definite multiple sclerosis (CDMS), Epstein-Barr nuclear antigen 1 (EBNA-1), clinically isolated syndrome (CIS), oligoclonal bands (OCBs), serum 25-hydroxyvitamin D3 (25-OH-D),
- MeSH
- Survival Analysis MeSH
- Adult MeSH
- Endonucleases MeSH
- Risk Assessment MeSH
- Immunoglobulin G analysis MeSH
- Nuclear Proteins analysis MeSH
- Cohort Studies MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Follow-Up Studies MeSH
- Oligoclonal Bands genetics MeSH
- Predictive Value of Tests MeSH
- Prognosis MeSH
- Disease Progression MeSH
- Multiple Sclerosis cerebrospinal fluid pathology MeSH
- Vitamin D blood MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Endonucleases MeSH
- Immunoglobulin G MeSH
- Nuclear Proteins MeSH
- Oligoclonal Bands MeSH
- SND1 protein, human MeSH Browser
- Vitamin D MeSH
BACKGROUND AND OBJECTIVE: We explored which clinical and biochemical variables predict conversion from clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS) in a large international cohort. METHODS: Thirty-three centres provided serum samples from 1047 CIS cases with at least two years' follow-up. Age, sex, clinical presentation, T2-hyperintense lesions, cerebrospinal fluid (CSF) oligoclonal bands (OCBs), CSF IgG index, CSF cell count, serum 25-hydroxyvitamin D3 (25-OH-D), cotinine and IgG titres against Epstein-Barr nuclear antigen 1 (EBNA-1) and cytomegalovirus were tested for association with risk of CDMS. RESULTS: At median follow-up of 4.31 years, 623 CIS cases converted to CDMS. Predictors of conversion in multivariable analyses were OCB (HR = 2.18, 95% CI = 1.71-2.77, p < 0.001), number of T2 lesions (two to nine lesions vs 0/1 lesions: HR = 1.97, 95% CI = 1.52-2.55, p < 0.001; >9 lesions vs 0/1 lesions: HR = 2.74, 95% CI = 2.04-3.68, p < 0.001) and age at CIS (HR per year inversely increase = 0.98, 95% CI = 0.98-0.99, p < 0.001). Lower 25-OH-D levels were associated with CDMS in univariable analysis, but this was attenuated in the multivariable model. OCB positivity was associated with higher EBNA-1 IgG titres. CONCLUSIONS: We validated MRI lesion load, OCB and age at CIS as the strongest independent predictors of conversion to CDMS in this multicentre setting. A role for vitamin D is suggested but requires further investigation.
C Mondino National Neurological Institute Italy
Centre of Multiple Sclerosis City Clinical Hospital 31 Russia
Clinic of Neurology Belgrade University School of Medicine Serbia
Department of Basic Medical Sciences Neuroscience and Sense Organs University of Bari Italy
Department of Health Sciences and IRCAD Eastern Piedmont University Italy
Department of Neurology and Immunology Hospital Ramón y Cajal Spain
Department of Neurology Charles University Prague Czech Republic
Department of Neurology CSF Laboratory and MS Outpatient Unit University of Ulm Germany
Department of Neurology Erasmus MC University Medical Center The Netherlands
Department of Neurology Glostrup Hospital University of Copenhagen Denmark
Department of Neurology Innsbruck Medical University Austria
Department of Neurology Istanbul University Turkey
Department of Neurology Medical Faculty Heinrich Heine University Germany
Department of Neurology Medical University of Graz Austria
Department of Neurology Medical University of Lublin Poland
Department of Neurology of Hospital Británico of Buenos Aires Argentina
Department of Neurology Université de Lyon Université Claude Bernard Lyon 1 France
Department of Neurology University of Genoa Italy
Department of Neurology University of Szeged Hungary
Department of Neurology University of Toulouse France
Department of Radiology Innsbruck Medical University Austria
Departments of Neurology and Biomedicine University Hospital Basel University of Basel Switzerland
Institute of Neuroscience and Physiology The Sahlgrenska Academy University of Gothenburg Sweden
MS Centre SCDU Neurology Head and Neck Department AOU Maggiore della Carità Italy
Neuroimmunology Unit Department of Clinical Neuroscience Karolinska Institutet Sweden
Unit of Functional Imaging Glostrup Hospital University of Copenhagen Denmark
References provided by Crossref.org
Drug Treatment of Clinically Isolated Syndrome
