One-year MRI scan predicts clinical response to interferon beta in multiple sclerosis

Background and purpose:  To define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing‐remitting multiple sclerosis (RR‐MS) patients with sustained disability progression during interferon beta (IFNB) treatment. Methods:  All patients receiv...

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Vydáno v:European journal of neurology Ročník 16; číslo 11; s. 1202 - 1209
Hlavní autoři: Prosperini, L., Gallo, V., Petsas, N., Borriello, G., Pozzilli, C.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Oxford, UK Blackwell Publishing Ltd 01.11.2009
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ISSN:1351-5101, 1468-1331, 1468-1331
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Abstract Background and purpose:  To define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing‐remitting multiple sclerosis (RR‐MS) patients with sustained disability progression during interferon beta (IFNB) treatment. Methods:  All patients receiving treatment with one of the available IFNB formulations for at least 1 year were included in this single‐centre, prospective and post‐marketing study. Demographic, clinical and MRI data were collected at IFNB start and at 1 year of therapy; patients were followed‐up at least yearly. Poor clinical response was defined as the occurrence of a sustained disability progression of ≥1 point in the Expanded Disability Status Scale (EDSS) during the follow‐up period. Results:  Out of 454 RR‐MS patients starting IFNB therapy, data coming from 394 patients with a mean follow‐up of 4.8 (2.4) years were analysed. Sixty patients were excluded because of too short follow‐up. Less than 1/3 (30.4%) of the patients satisfied the criterion of ‘poor responders’. Patients presenting new lesions on T2‐weighted MRI scan after 1 year of therapy (compared with baseline) had a higher risk of being poor responder to treatment with IFNB during the follow‐up period (HR 16.8, 95% CI 7.6–37.1, P < 0.001). An augmented risk increasing the number of lesions was observed, with a 10‐fold increase for each new lesion. Conclusions:  Developing new T2‐hyperintense lesions during IFNB treatment was the best predictor of long‐term poor response to therapy. MRI scans performed after 1 year of IFNB treatment may be useful in contributing to early identification of poor responders.
AbstractList To define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing-remitting multiple sclerosis (RR-MS) patients with sustained disability progression during interferon beta (IFNB) treatment.BACKGROUND AND PURPOSETo define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing-remitting multiple sclerosis (RR-MS) patients with sustained disability progression during interferon beta (IFNB) treatment.All patients receiving treatment with one of the available IFNB formulations for at least 1 year were included in this single-centre, prospective and post-marketing study. Demographic, clinical and MRI data were collected at IFNB start and at 1 year of therapy; patients were followed-up at least yearly. Poor clinical response was defined as the occurrence of a sustained disability progression of > or =1 point in the Expanded Disability Status Scale (EDSS) during the follow-up period.METHODSAll patients receiving treatment with one of the available IFNB formulations for at least 1 year were included in this single-centre, prospective and post-marketing study. Demographic, clinical and MRI data were collected at IFNB start and at 1 year of therapy; patients were followed-up at least yearly. Poor clinical response was defined as the occurrence of a sustained disability progression of > or =1 point in the Expanded Disability Status Scale (EDSS) during the follow-up period.Out of 454 RR-MS patients starting IFNB therapy, data coming from 394 patients with a mean follow-up of 4.8 (2.4) years were analysed. Sixty patients were excluded because of too short follow-up. Less than 1/3 (30.4%) of the patients satisfied the criterion of 'poor responders'. Patients presenting new lesions on T2-weighted MRI scan after 1 year of therapy (compared with baseline) had a higher risk of being poor responder to treatment with IFNB during the follow-up period (HR 16.8, 95% CI 7.6-37.1, P < 0.001). An augmented risk increasing the number of lesions was observed, with a 10-fold increase for each new lesion.RESULTSOut of 454 RR-MS patients starting IFNB therapy, data coming from 394 patients with a mean follow-up of 4.8 (2.4) years were analysed. Sixty patients were excluded because of too short follow-up. Less than 1/3 (30.4%) of the patients satisfied the criterion of 'poor responders'. Patients presenting new lesions on T2-weighted MRI scan after 1 year of therapy (compared with baseline) had a higher risk of being poor responder to treatment with IFNB during the follow-up period (HR 16.8, 95% CI 7.6-37.1, P < 0.001). An augmented risk increasing the number of lesions was observed, with a 10-fold increase for each new lesion.Developing new T2-hyperintense lesions during IFNB treatment was the best predictor of long-term poor response to therapy. MRI scans performed after 1 year of IFNB treatment may be useful in contributing to early identification of poor responders.CONCLUSIONSDeveloping new T2-hyperintense lesions during IFNB treatment was the best predictor of long-term poor response to therapy. MRI scans performed after 1 year of IFNB treatment may be useful in contributing to early identification of poor responders.
To define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing-remitting multiple sclerosis (RR-MS) patients with sustained disability progression during interferon beta (IFNB) treatment. All patients receiving treatment with one of the available IFNB formulations for at least 1 year were included in this single-centre, prospective and post-marketing study. Demographic, clinical and MRI data were collected at IFNB start and at 1 year of therapy; patients were followed-up at least yearly. Poor clinical response was defined as the occurrence of a sustained disability progression of > or =1 point in the Expanded Disability Status Scale (EDSS) during the follow-up period. Out of 454 RR-MS patients starting IFNB therapy, data coming from 394 patients with a mean follow-up of 4.8 (2.4) years were analysed. Sixty patients were excluded because of too short follow-up. Less than 1/3 (30.4%) of the patients satisfied the criterion of 'poor responders'. Patients presenting new lesions on T2-weighted MRI scan after 1 year of therapy (compared with baseline) had a higher risk of being poor responder to treatment with IFNB during the follow-up period (HR 16.8, 95% CI 7.6-37.1, P < 0.001). An augmented risk increasing the number of lesions was observed, with a 10-fold increase for each new lesion. Developing new T2-hyperintense lesions during IFNB treatment was the best predictor of long-term poor response to therapy. MRI scans performed after 1 year of IFNB treatment may be useful in contributing to early identification of poor responders.
Background and purpose:  To define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing‐remitting multiple sclerosis (RR‐MS) patients with sustained disability progression during interferon beta (IFNB) treatment. Methods:  All patients receiving treatment with one of the available IFNB formulations for at least 1 year were included in this single‐centre, prospective and post‐marketing study. Demographic, clinical and MRI data were collected at IFNB start and at 1 year of therapy; patients were followed‐up at least yearly. Poor clinical response was defined as the occurrence of a sustained disability progression of ≥1 point in the Expanded Disability Status Scale (EDSS) during the follow‐up period. Results:  Out of 454 RR‐MS patients starting IFNB therapy, data coming from 394 patients with a mean follow‐up of 4.8 (2.4) years were analysed. Sixty patients were excluded because of too short follow‐up. Less than 1/3 (30.4%) of the patients satisfied the criterion of ‘poor responders’. Patients presenting new lesions on T2‐weighted MRI scan after 1 year of therapy (compared with baseline) had a higher risk of being poor responder to treatment with IFNB during the follow‐up period (HR 16.8, 95% CI 7.6–37.1, P  < 0.001). An augmented risk increasing the number of lesions was observed, with a 10‐fold increase for each new lesion. Conclusions:  Developing new T2‐hyperintense lesions during IFNB treatment was the best predictor of long‐term poor response to therapy. MRI scans performed after 1 year of IFNB treatment may be useful in contributing to early identification of poor responders.
Background and purpose:  To define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing‐remitting multiple sclerosis (RR‐MS) patients with sustained disability progression during interferon beta (IFNB) treatment. Methods:  All patients receiving treatment with one of the available IFNB formulations for at least 1 year were included in this single‐centre, prospective and post‐marketing study. Demographic, clinical and MRI data were collected at IFNB start and at 1 year of therapy; patients were followed‐up at least yearly. Poor clinical response was defined as the occurrence of a sustained disability progression of ≥1 point in the Expanded Disability Status Scale (EDSS) during the follow‐up period. Results:  Out of 454 RR‐MS patients starting IFNB therapy, data coming from 394 patients with a mean follow‐up of 4.8 (2.4) years were analysed. Sixty patients were excluded because of too short follow‐up. Less than 1/3 (30.4%) of the patients satisfied the criterion of ‘poor responders’. Patients presenting new lesions on T2‐weighted MRI scan after 1 year of therapy (compared with baseline) had a higher risk of being poor responder to treatment with IFNB during the follow‐up period (HR 16.8, 95% CI 7.6–37.1, P < 0.001). An augmented risk increasing the number of lesions was observed, with a 10‐fold increase for each new lesion. Conclusions:  Developing new T2‐hyperintense lesions during IFNB treatment was the best predictor of long‐term poor response to therapy. MRI scans performed after 1 year of IFNB treatment may be useful in contributing to early identification of poor responders.
Background and purpose: To define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing-remitting multiple sclerosis (RR-MS) patients with sustained disability progression during interferon beta (IFNB) treatment.Methods: All patients receiving treatment with one of the available IFNB formulations for at least 1 year were included in this single-centre, prospective and post-marketing study. Demographic, clinical and MRI data were collected at IFNB start and at 1 year of therapy; patients were followed-up at least yearly. Poor clinical response was defined as the occurrence of a sustained disability progression of greater than or equal to 1 point in the Expanded Disability Status Scale (EDSS) during the follow-up period.Results: Out of 454 RR-MS patients starting IFNB therapy, data coming from 394 patients with a mean follow-up of 4.8 (2.4) years were analysed. Sixty patients were excluded because of too short follow-up. Less than 1-3 (30.4%) of the patients satisfied the criterion of 'poor responders'. Patients presenting new lesions on T2-weighted MRI scan after 1 year of therapy (compared with baseline) had a higher risk of being poor responder to treatment with IFNB during the follow-up period (HR 16.8, 95% CI 7.6-37.1, P < 0.001). An augmented risk increasing the number of lesions was observed, with a 10-fold increase for each new lesion.Conclusions: Developing new T2-hyperintense lesions during IFNB treatment was the best predictor of long-term poor response to therapy. MRI scans performed after 1 year of IFNB treatment may be useful in contributing to early identification of poor responders.
Author Gallo, V.
Prosperini, L.
Pozzilli, C.
Petsas, N.
Borriello, G.
Author_xml – sequence: 1
  givenname: L.
  surname: Prosperini
  fullname: Prosperini, L.
  organization: Multiple Sclerosis Centre, Department of Neurological Sciences, S. Andrea Hospital, "La Sapienza" University, Rome, Italy
– sequence: 2
  givenname: V.
  surname: Gallo
  fullname: Gallo, V.
  organization: Multiple Sclerosis Centre, Department of Neurological Sciences, S. Andrea Hospital, "La Sapienza" University, Rome, Italy
– sequence: 3
  givenname: N.
  surname: Petsas
  fullname: Petsas, N.
  organization: Neurological Centre of Latium, Rome, Italy
– sequence: 4
  givenname: G.
  surname: Borriello
  fullname: Borriello, G.
  organization: Multiple Sclerosis Centre, Department of Neurological Sciences, S. Andrea Hospital, "La Sapienza" University, Rome, Italy
– sequence: 5
  givenname: C.
  surname: Pozzilli
  fullname: Pozzilli, C.
  organization: Multiple Sclerosis Centre, Department of Neurological Sciences, S. Andrea Hospital, "La Sapienza" University, Rome, Italy
BackLink https://www.ncbi.nlm.nih.gov/pubmed/19538207$$D View this record in MEDLINE/PubMed
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References Paty DW, Li DK. Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. II. MRI analysis results of a multicenter, randomized, double-blind, placebo-controlled trial. UBC MS/MRI Study Group and the IFN Beta Multiple Sclerosis Study Group. Neurology 1993; 43: 662-667.
Trojano M, Pellegrini F, Fuiani A, et al. New natural history of interferon beta-treated relapsing multiple sclerosis. Ann Neurol 2007; 61: 300-306.
Miller DH, Albert PS, Barkhof F, et al. Guidelines for the use of magnetic resonance techniques in monitoring the treatment of multiple sclerosis. US National MS Society Task Force. Ann Neurol 1996; 39: 6-16.
Tomassini V, Paolillo A, Russo P, et al. Predictors of long-term clinical response to interferon beta therapy in relapsing multiple sclerosis. J Neurol 2006; 253: 287-293.
Li DK, Paty DW. Magnetic Resonance Imaging results of the PRISMS trial: a randomized, double-blind, placebo-controlled study of interferon beta-1a in relapsing-remitting multiple sclerosis. Prevention of relapses and disability by interferon beta-1a subcutaneously in multiple sclerosis. Ann Neurol 1999; 42: 197-206.
Rio J, Rovira A, Tintoré M, et al. Relationship between MRI lesion activity and response to IFN-beta in relapsing-remitting multiple sclerosis patients. Mult Scler 2008; 14: 479-484.
Miller DH, Barkhof F, Frank JA, et al. Measurement of atrophy in multiple sclerosis: pathological basis, methodological aspects and clinical relevance. Brain 2002; 125: 1676-1695.
The IFN beta Study Group. Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. I. Clinical results of a multicenter, randomized, double-blind, placebo-controlled trial. The IFN Beta Multiple Sclerosis Study Group. Neurology 1993; 43: 655-661.
Jacobs LD, Cookfair DL, Rudick RA, et al. Intramuscular interferon beta-1a for disease progression in relapsing multiple sclerosis. The Multiple Sclerosis Collaborative Research Group (MSCRG). Ann Neurol 1996; 39: 285-294.
O'Rourke K, Walsh C, Hutchinson M. Outcome of Beta-interferon treatment in relapsing-remitting multiple sclerosis: a Bayesian analysis. J Neurol 2007; 254: 1547-1554.
Koudriavtseva T, Pozzilli C, Fiorelli M, et al. Determinants of Gd-enhanced MRI response to IFN beta-1a treatment in relapsing-remitting multiple sclerosis. Mult Scler 1998; 4: 403-407.
Rio J, Tintoré M, Nos C, et al. Interferon beta in relapsing-remitting multiple sclerosis: an eight years experience in a specialist multiple sclerosis centre. J Neurol 2005; 252: 795-800.
O'Rourke K, Walsh C, Antonelli G, et al. Predicting beta-interferon failure in relapsing-remitting multiple sclerosis. Mult Scler 2007; 13: 336-342.
Rio J, Nos C, Tintoré M, et al. Defining the response to interferon beta in relapsing-remitting multiple sclerosis patients. Ann Neurol 2006; 59: 344-352.
Fisher E, Rudick RA, Simon JH, et al. Eight year follow-up study of brain atrophy in patients with MS. Neurology 2002; 59: 1412-1420.
PRISMS (Prevention of Relapses and Disability by Interferon beta-1a Subcutaneously in Multiple Sclerosis) Study Group. Randomised double-blind placebo-controlled study of interferon beta-1a in relapsing/remitting multiple sclerosis. Lancet 1998; 352: 1498-1504.
Durelli L, Berbero P, Bergui M, et al. MRI activity and neutralizing antibody as predictor of response to IFNB treatment in MS. J Neurol Neurosurg Psychiatry 2008; 79: 646-651.
McFarland HF, Barkhof F, Antel J, Miller DH. The role of MRI as surrogate outcome measure in multiple sclerosis. Mult Scler 2002; 8: 40-51.
Miller DH, Grossman R, Reingold S, et al. The role of magnetic resonance techniques in understanding and managing multiple sclerosis. Brain 1998; 121: 3-24.
Roullet E, Dominique P, Le Canuet P, et al. Application of different criteria for clinical response to beta-interferon in relapsing-remitting multiple sclerosis. Neurology 2003; 60(Suppl. 1): A168.
Rudick RA, Lee JC, Simon J, et al. Defining interferon beta response status in multiple sclerosis patients. Ann Neurol 2004; 56: 548-555.
Kurtzke JF. Rating neurological impairment in multiple sclerosis. An expanded disability status scale (EDSS). Neurology 2003; 33: 1444-1452.
Dubois BD, Keenan E, Porter BE, et al. Interferon beta in multiple sclerosis: experience in a British specialist multiple sclerosis centre. J Neurol Neurosurg Psychiatry 2003; 74: 946-949.
Simon JH, Jacobs LD, Campion M, et al. Magnetic resonance studies of intramuscular interferon beta-1a for relapsing multiple sclerosis. The Multiple Sclerosis Collaborative research Group. Ann Neurol 1998; 43: 79-87.
Rio J, Porcel J, Tellez N, et al. Factors related with treatment adherence to interferon beta and glatiramer acetate therapy in multiple sclerosis. Mult Scler 2005; 11: 306-309.
McDonald WI, Compston A, Edan G, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines form the International Panel on the diagnosis of Multiple Sclerosis. Ann Neurol 2001; 50: 121-127.
Waubant E, Vukusic S, Gignoux L, et al. Clinical characteristics of responders to interferon therapy for relapsing MS. Neurology 2003; 61: 184-189.
Sormani MP, Bruzzi P, Beckmann K, et al. The distribution of magnetic resonance imaging response to interferon beta-1b in multiple sclerosis. J Neurol 2005; 252: 1455-1458.
Tremlett HL, Oger J. Interrupted therapy: stopping and switching of the beta-interferons prescribed for MS. Neurology 2003; 61: 551-554.
Freedman MS, Patry DG, Grand'Maison F, et al. Canadian MS Working Group. Treatment optimization in multiple sclerosis. Can J Neurol Sci 2004; 31: 157-168.
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References_xml – reference: Roullet E, Dominique P, Le Canuet P, et al. Application of different criteria for clinical response to beta-interferon in relapsing-remitting multiple sclerosis. Neurology 2003; 60(Suppl. 1): A168.
– reference: Rio J, Porcel J, Tellez N, et al. Factors related with treatment adherence to interferon beta and glatiramer acetate therapy in multiple sclerosis. Mult Scler 2005; 11: 306-309.
– reference: Paty DW, Li DK. Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. II. MRI analysis results of a multicenter, randomized, double-blind, placebo-controlled trial. UBC MS/MRI Study Group and the IFN Beta Multiple Sclerosis Study Group. Neurology 1993; 43: 662-667.
– reference: Jacobs LD, Cookfair DL, Rudick RA, et al. Intramuscular interferon beta-1a for disease progression in relapsing multiple sclerosis. The Multiple Sclerosis Collaborative Research Group (MSCRG). Ann Neurol 1996; 39: 285-294.
– reference: Kurtzke JF. Rating neurological impairment in multiple sclerosis. An expanded disability status scale (EDSS). Neurology 2003; 33: 1444-1452.
– reference: Simon JH, Jacobs LD, Campion M, et al. Magnetic resonance studies of intramuscular interferon beta-1a for relapsing multiple sclerosis. The Multiple Sclerosis Collaborative research Group. Ann Neurol 1998; 43: 79-87.
– reference: The IFN beta Study Group. Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. I. Clinical results of a multicenter, randomized, double-blind, placebo-controlled trial. The IFN Beta Multiple Sclerosis Study Group. Neurology 1993; 43: 655-661.
– reference: Tomassini V, Paolillo A, Russo P, et al. Predictors of long-term clinical response to interferon beta therapy in relapsing multiple sclerosis. J Neurol 2006; 253: 287-293.
– reference: Miller DH, Albert PS, Barkhof F, et al. Guidelines for the use of magnetic resonance techniques in monitoring the treatment of multiple sclerosis. US National MS Society Task Force. Ann Neurol 1996; 39: 6-16.
– reference: Miller DH, Grossman R, Reingold S, et al. The role of magnetic resonance techniques in understanding and managing multiple sclerosis. Brain 1998; 121: 3-24.
– reference: O'Rourke K, Walsh C, Antonelli G, et al. Predicting beta-interferon failure in relapsing-remitting multiple sclerosis. Mult Scler 2007; 13: 336-342.
– reference: Dubois BD, Keenan E, Porter BE, et al. Interferon beta in multiple sclerosis: experience in a British specialist multiple sclerosis centre. J Neurol Neurosurg Psychiatry 2003; 74: 946-949.
– reference: Rio J, Rovira A, Tintoré M, et al. Relationship between MRI lesion activity and response to IFN-beta in relapsing-remitting multiple sclerosis patients. Mult Scler 2008; 14: 479-484.
– reference: McDonald WI, Compston A, Edan G, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines form the International Panel on the diagnosis of Multiple Sclerosis. Ann Neurol 2001; 50: 121-127.
– reference: O'Rourke K, Walsh C, Hutchinson M. Outcome of Beta-interferon treatment in relapsing-remitting multiple sclerosis: a Bayesian analysis. J Neurol 2007; 254: 1547-1554.
– reference: Rio J, Tintoré M, Nos C, et al. Interferon beta in relapsing-remitting multiple sclerosis: an eight years experience in a specialist multiple sclerosis centre. J Neurol 2005; 252: 795-800.
– reference: Rudick RA, Lee JC, Simon J, et al. Defining interferon beta response status in multiple sclerosis patients. Ann Neurol 2004; 56: 548-555.
– reference: Tremlett HL, Oger J. Interrupted therapy: stopping and switching of the beta-interferons prescribed for MS. Neurology 2003; 61: 551-554.
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– reference: Freedman MS, Patry DG, Grand'Maison F, et al. Canadian MS Working Group. Treatment optimization in multiple sclerosis. Can J Neurol Sci 2004; 31: 157-168.
– reference: Fisher E, Rudick RA, Simon JH, et al. Eight year follow-up study of brain atrophy in patients with MS. Neurology 2002; 59: 1412-1420.
– reference: McFarland HF, Barkhof F, Antel J, Miller DH. The role of MRI as surrogate outcome measure in multiple sclerosis. Mult Scler 2002; 8: 40-51.
– reference: Trojano M, Pellegrini F, Fuiani A, et al. New natural history of interferon beta-treated relapsing multiple sclerosis. Ann Neurol 2007; 61: 300-306.
– reference: Miller DH, Barkhof F, Frank JA, et al. Measurement of atrophy in multiple sclerosis: pathological basis, methodological aspects and clinical relevance. Brain 2002; 125: 1676-1695.
– reference: Li DK, Paty DW. Magnetic Resonance Imaging results of the PRISMS trial: a randomized, double-blind, placebo-controlled study of interferon beta-1a in relapsing-remitting multiple sclerosis. Prevention of relapses and disability by interferon beta-1a subcutaneously in multiple sclerosis. Ann Neurol 1999; 42: 197-206.
– reference: Waubant E, Vukusic S, Gignoux L, et al. Clinical characteristics of responders to interferon therapy for relapsing MS. Neurology 2003; 61: 184-189.
– reference: Rio J, Nos C, Tintoré M, et al. Defining the response to interferon beta in relapsing-remitting multiple sclerosis patients. Ann Neurol 2006; 59: 344-352.
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Snippet Background and purpose:  To define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing‐remitting...
Background and purpose:  To define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing‐remitting...
To define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing-remitting multiple sclerosis (RR-MS)...
Background and purpose: To define the predictive value of clinical and magnetic resonance imaging (MRI) characteristics in identifying relapsing-remitting...
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SubjectTerms Adolescent
Adult
Age of Onset
Child
Disease Progression
Female
Follow-Up Studies
Humans
interferon beta
Interferon-beta - therapeutic use
Longitudinal Studies
magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Middle Aged
multiple sclerosis
Multiple Sclerosis, Relapsing-Remitting - drug therapy
Predictive Value of Tests
response to therapy
Risk Factors
Severity of Illness Index
Time Factors
Treatment Outcome
Title One-year MRI scan predicts clinical response to interferon beta in multiple sclerosis
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