I have RRMS and just started treatment. How often should I be getting an MRI?

Question: I have RRMS and just started treatment. How often should I be getting an MRI?

Answer: A presentation at the 17th Meeting of the European Neurological Society in June 2007 presented data suggesting that how people respond to interferon-based disease-modifying therapies in the first year of treatment indicates future response. This class of drugs includes Avonex, Rebif and Betaseron. However, it was not clear which of these the study participants were taking.

The study was a retrospective study among 345 Italian patients with relapsing-remitting MS (RRMS) who had been on treatment an average of 4.5 years. Researchers analyzed disability scores and MRIs performed after patients had been on interferon-beta for one year and found that:

• Patients who had a longer disease duration and higher disability when they started treatment were more likely to have a poor response to the treatment.
• Patients experiencing a relapse within the first year of treatment were twice as likely to have a poor response over the study period.

However, the strongest indicator that patients would be poor responders to treatment came from MRIs:

• Patients with one active (gadolinium-enhanced) lesion after one year of treatment were 3.4 times as likely to have a poor response to treatment.
• Patients with an increase in overall lesions were 8.6 times more likely to have a poor response to treatment.

"Poor response to treatment" was defined as an increase of at least one point on the Expanded Disability Status Scale (EDSS).

Bottom line: Researchers of this study say that patients on interferon-beta treatment should have an MRI performed at the end of the first year of treatment to determine if they are responding adequately to the treatment. This study did not include patients on Copaxone or Tysabri.

Note: This study has not been formally published in a peer-reviewed journal at this date. Therefore, these results should be considered to be preliminary. However, the results support those of an earlier study conducted by the same group that was published in the Journal of Neurology in 2006 (see sources below).

_Sources:

Pozzilli, C. Early Predictors of Poor Response to Interferon Beta Therapy in a Cohort of Relapsing-remitting Multiple Sclerosis. Abstract P294. Presented at 17th Meeting of the European Neurological Society. Rhodes, Greece; June 2007.

Tomassini V, Paolillo A, Russo P, Giugni E, Prosperini L, Gasperini C, Antonelli G, Bastianello S, Pozzilli C.Predictors of long-term clinical response to interferon beta therapy in relapsing multiple sclerosis. J Neurol. 2006 Mar;253(3):287-93.