Disease-modifying therapies modulate retinal atrophy in multiple sclerosis: A retrospective study

Julia Button, Omar Al-Louzi, Andrew Lang, Pavan Bhargava, Scott D. Newsome, Teresa Frohman, Laura J. Balcer, Elliot M. Frohman, Jerry Prince, Peter A. Calabresi, Shiv Saidha

Research output: Contribution to journalArticle

Abstract

Objective: To retrospectively investigate whether disease-modifying therapies (DMTs) exert differential effects on rates of retinal atrophy in relapsing-remitting multiple sclerosis (RRMS), as assessed using optical coherence tomography (OCT). Methods: A total of 402 patients with RRMS followed at the Johns Hopkins MS Center who underwent Cirrus-HD OCT were assessed for eligibility. Inclusion criteria included at least 1 year of OCT follow-up and adherence to a single DMT during the period of follow-up. Combined thickness of the ganglion cell + inner plexiform (GCIP) and other retinal layers was computed utilizing automated macular segmentation. Retinal thickness changes were analyzed using mixed-effects linear regression. Results: The effects of glatiramer acetate (GA; n = 48), natalizumab (NAT; n = 46), and interferon-β-1a subcutaneously (IFNSC; n = 35) and intramuscularly (IFNIM; n = 28) were assessed. Baseline analyses revealed no significant differences between groups in terms of age, sex, optic neuritis history, or follow-up duration. During follow-up, relative to NAT-treated patients, IFNSC - and GA-treated patients exhibited 0.37 μ m/y (p < 0.001) and 0.14 μm/y (p = 0.035) faster rates of GCIP thinning, respectively, adjusting for the interval between initiation of DMT and OCT monitoring (gap time), age, sex, relapses, and disease duration. In the IFNSC group, GCIP thinning was 1.53 m/y faster during the first year of therapy vs during the time interval afterwards (p < 0.001). Conclusions: Rates of GCIP atrophy in patients with RRMS vary according to DMT utilization. Our findings support OCT for monitoring neurodegenerative treatment effects in the retina, an easily accessible tissue, and as a practical outcome measure in RRMS clinical trials.

LanguageEnglish (US)
Pages525-532
Number of pages8
JournalNeurology
Volume88
Issue number6
DOIs
StatePublished - Feb 7 2017

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Optical Coherence Tomography
Multiple Sclerosis
Atrophy
Relapsing-Remitting Multiple Sclerosis
Retrospective Studies
Ganglia
Therapeutics
Optic Neuritis
Retina
Linear Models
Outcome Assessment (Health Care)
Clinical Trials
Recurrence
N-acetyltalosaminuronic acid

ASJC Scopus subject areas

  • Clinical Neurology

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Disease-modifying therapies modulate retinal atrophy in multiple sclerosis : A retrospective study. / Button, Julia; Al-Louzi, Omar; Lang, Andrew; Bhargava, Pavan; Newsome, Scott D.; Frohman, Teresa; Balcer, Laura J.; Frohman, Elliot M.; Prince, Jerry; Calabresi, Peter A.; Saidha, Shiv.

In: Neurology, Vol. 88, No. 6, 07.02.2017, p. 525-532.

Research output: Contribution to journalArticle

Button, Julia ; Al-Louzi, Omar ; Lang, Andrew ; Bhargava, Pavan ; Newsome, Scott D. ; Frohman, Teresa ; Balcer, Laura J. ; Frohman, Elliot M. ; Prince, Jerry ; Calabresi, Peter A. ; Saidha, Shiv. / Disease-modifying therapies modulate retinal atrophy in multiple sclerosis : A retrospective study. In: Neurology. 2017 ; Vol. 88, No. 6. pp. 525-532
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abstract = "Objective: To retrospectively investigate whether disease-modifying therapies (DMTs) exert differential effects on rates of retinal atrophy in relapsing-remitting multiple sclerosis (RRMS), as assessed using optical coherence tomography (OCT). Methods: A total of 402 patients with RRMS followed at the Johns Hopkins MS Center who underwent Cirrus-HD OCT were assessed for eligibility. Inclusion criteria included at least 1 year of OCT follow-up and adherence to a single DMT during the period of follow-up. Combined thickness of the ganglion cell + inner plexiform (GCIP) and other retinal layers was computed utilizing automated macular segmentation. Retinal thickness changes were analyzed using mixed-effects linear regression. Results: The effects of glatiramer acetate (GA; n = 48), natalizumab (NAT; n = 46), and interferon-β-1a subcutaneously (IFNSC; n = 35) and intramuscularly (IFNIM; n = 28) were assessed. Baseline analyses revealed no significant differences between groups in terms of age, sex, optic neuritis history, or follow-up duration. During follow-up, relative to NAT-treated patients, IFNSC - and GA-treated patients exhibited 0.37 μ m/y (p < 0.001) and 0.14 μm/y (p = 0.035) faster rates of GCIP thinning, respectively, adjusting for the interval between initiation of DMT and OCT monitoring (gap time), age, sex, relapses, and disease duration. In the IFNSC group, GCIP thinning was 1.53 m/y faster during the first year of therapy vs during the time interval afterwards (p < 0.001). Conclusions: Rates of GCIP atrophy in patients with RRMS vary according to DMT utilization. Our findings support OCT for monitoring neurodegenerative treatment effects in the retina, an easily accessible tissue, and as a practical outcome measure in RRMS clinical trials.",
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T2 - Neurology

AU - Button,Julia

AU - Al-Louzi,Omar

AU - Lang,Andrew

AU - Bhargava,Pavan

AU - Newsome,Scott D.

AU - Frohman,Teresa

AU - Balcer,Laura J.

AU - Frohman,Elliot M.

AU - Prince,Jerry

AU - Calabresi,Peter A.

AU - Saidha,Shiv

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AB - Objective: To retrospectively investigate whether disease-modifying therapies (DMTs) exert differential effects on rates of retinal atrophy in relapsing-remitting multiple sclerosis (RRMS), as assessed using optical coherence tomography (OCT). Methods: A total of 402 patients with RRMS followed at the Johns Hopkins MS Center who underwent Cirrus-HD OCT were assessed for eligibility. Inclusion criteria included at least 1 year of OCT follow-up and adherence to a single DMT during the period of follow-up. Combined thickness of the ganglion cell + inner plexiform (GCIP) and other retinal layers was computed utilizing automated macular segmentation. Retinal thickness changes were analyzed using mixed-effects linear regression. Results: The effects of glatiramer acetate (GA; n = 48), natalizumab (NAT; n = 46), and interferon-β-1a subcutaneously (IFNSC; n = 35) and intramuscularly (IFNIM; n = 28) were assessed. Baseline analyses revealed no significant differences between groups in terms of age, sex, optic neuritis history, or follow-up duration. During follow-up, relative to NAT-treated patients, IFNSC - and GA-treated patients exhibited 0.37 μ m/y (p < 0.001) and 0.14 μm/y (p = 0.035) faster rates of GCIP thinning, respectively, adjusting for the interval between initiation of DMT and OCT monitoring (gap time), age, sex, relapses, and disease duration. In the IFNSC group, GCIP thinning was 1.53 m/y faster during the first year of therapy vs during the time interval afterwards (p < 0.001). Conclusions: Rates of GCIP atrophy in patients with RRMS vary according to DMT utilization. Our findings support OCT for monitoring neurodegenerative treatment effects in the retina, an easily accessible tissue, and as a practical outcome measure in RRMS clinical trials.

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