Predictors of short-term disease activity following a first clinical demyelinating event: Analysis of the CHAMPS placebo group

P. O'Connor, P. Fleming, T. Gray, L. Jacobs, C. Miller, F. Munschauer, R. P. Kinkel, D. Bolibrush, J. Cohen, M. Freedman, U. Webb, H. Rabinowicz, L. M. Metz, D. Patry, M. Yeung, S. Peters, S. Hashimoto, W. Morrison, J. Oger, H. PanitchK. Costello, C. Bever, W. Stuart, D. Court, D. Stuart, C. Tornatore, D. Bartlett, J. Richert, P. Duquette, R. Dubois, G. Bernier, T. Scott, L. Pappert, J. Brillman, W. Felton, T. Anderson, J. Astruc, J. Rose, J. Kline, J. Burns, T. Murray, P. Weldon, V. Bhan, C. E. Maxner, M. Wall, L. Vining, T. Grabowski, B. Apatoff, C. Orapello, J. Friedman, S. Galetta, D. Pfohl, G. Liu, G. Rice, T. Bental, P. Mandalfino, E. Eggenberger, D. Snider, D. Kaufman, J. Guarnaccia, M. Shepard, J. Goldstein, M. Reiss, E. Carter, G. Glista, L. Rolak, L. Scheller, D. Jacobson, J. Warner, A. Goodman, M. Petrie, D. Mattson, K. Karlin, A. Wallin, D. Stefoski, S. Brod, E. Cerretta, J. Wolinsky, D. Arnold, R. Arnoutelis, L. Durcan, M. Kupersmith, L. Cappolino, J. Herbert, J. Rosenberg, D. McHugh, A. Blumenfeld, C. Smith, D. Kuder, S. Hamilton, S. Thurston, J. McGee, J. O'Bannon, M. Kaufman, M. Butler, S. Putnam, K. Rammohan, A. Siffort, J. Lynn, J. Selhorst, E. Holzemer, G. Hayat, A. Tselis, C. Coon, R. Lisak, S. Wray, P. Sexton, J. Lehrich, S. Cook, A. Jotkowitz, S. Bansil, N. Newman, J. Brown, P. Pennell, J. Gilmore, J. Carter, J. Buckner, R. Caselli, L. Kerson, M. Camasso, G. Donneief, J. Cooper, B. Richardson, C. Kung, J. Goodwin, T. Johnson, A. Gulati, T. Hedges, C. Yardley, T. Tran, W. Brown, B. Ehrenberg, S. Horowitz, A. Bonnett, R. Burger, J. Javerbaum, C. Griffin, R. J. Whaley, D. Jeffery, S. E. Jackson, E. Bastings, L. Kasper, K. Ryan, J. Bernat, M. Mass, S. Cooper Hanel, D. Bourdette, J. Guy, M. Wilson, M. Greer, C. Lucchinetti, M. Botten, J. Noseworthy, A. Walker, B. Muntz, W. Tyor, J. Simon, M. Meyer, R. Leek, C. Gustafson, D. Singel, B. Quandt, D. E. Miller, B. Coombs, A. Cajade-Law, M. Lajaunie, E. Escott, A. Miller, T. Vollmer, C. Brownscheidle, T. J. Murray, J. Antel, L. Myers, G. Birnbaum, S. Reingold, R. Burde, W. Sibley, J. Ware, N. Blanchard, K. Lloyd, H. Park, A. Sandrock, N. Simonian, P. Slasor, F. Votruba, K. White, R. W. Beck, D. L. Chandler, S. Cole

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

We evaluated 190 patients in the placebo group of the CHAMPS trial in order to assess factors associated with short-term clinical and brain magnetic resonance imaging (MRI) outcomes in patients with a first clinical demyelinating event involving the optic nerve, spinal cord, or brainstem/cerebellum, and subclinical demyelination on brain MRI. The two study outcomes were 1) development of clinically definite multiple sclerosis (CDMS) and 2) development of CDMS or two or more new or enlarging brain MRI T2 lesions. The presence of godolinium (Gd)-enhancing lesions on the baseline scan was the only MRI characteristic associated with a higher risk of both the clinical and combined outcomes (p=0.003 and <0.001, respectively). The only demographic or clinical characteristic associated with an increased risk of these outcomes was younger age (p<0.001 for both outcomes). The lowest risk subgroups we could define had a 30% risk of CDMS and a 65% risk of the combined clinical/MRI outcome. Our results indicate that all patients presenting with a first demyelinating event who also have brain MRI evidence of subclinical demyelination have at least a moderate risk of short-term disease activity. This finding provides support for initiating disease-modifying therapy at the time of the first demyelinating event in patients meeting the CHAMPS enrollment criteria.

Original languageEnglish (US)
Pages (from-to)405-409
Number of pages5
JournalMultiple Sclerosis
Volume8
Issue number5
DOIs
StatePublished - Oct 2002

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Keywords

  • Brain MRI
  • Multiple sclerosis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

O'Connor, P., Fleming, P., Gray, T., Jacobs, L., Miller, C., Munschauer, F., Kinkel, R. P., Bolibrush, D., Cohen, J., Freedman, M., Webb, U., Rabinowicz, H., Metz, L. M., Patry, D., Yeung, M., Peters, S., Hashimoto, S., Morrison, W., Oger, J., ... Cole, S. (2002). Predictors of short-term disease activity following a first clinical demyelinating event: Analysis of the CHAMPS placebo group. Multiple Sclerosis, 8(5), 405-409. https://doi.org/10.1191/1352458502ms825oa