Clinical Topics

Higher Efficacy DMTs Reduce MS Brain Atrophy

by U.S. Medicine

June 26, 2019

BETHESDA, MD—How do disease-modifying therapies (DMTs) affect region-specific brain atrophy in multiple sclerosis? A recent study sought to answer that question.

Researchers from the Center for Neuroscience and Regenerative Medicine, at The Henry M. Jackson Foundation for the Advancement of Military Medicine and Johns Hopkins University School of Medicine retrospectively evaluated a nonrandomized, observational cohort of MS patients followed with annual brain magnetic resonance imaging. The study team obtained whole brain, subcortical gray matter, cortical GM and cerebral white matter volume fractions.

At the same time, the study published in the journal Multiple Sclerosis said that DMTs were categorized as higher (DMT-H: natalizumab and rituximab) or lower (DMT-L: interferon-beta and glatiramer acetate) efficacy.1

Analysis occurred in participants who had been on a DMT for  more than six months prior to baseline and had at least one follow-up MRI while on DMTs in the same category. The study was completed by 78 participants, with mean follow-up of 2.4 years.

Results indicated that annualized rates of thalamic (-0.15% vs. -0.81%; p = 0.001) and putaminal (-0.27% vs. -0.73%; p = 0.001) atrophy were slower during DMT-H compared to DMT-L epochs. The results remained significant in multivariate analyses, including demographics, clinical characteristics and T2 lesion volume.

“DMT-H treatment may be associated with slower rates of subcortical GM atrophy, especially of the thalamus and putamen,” the study authors concluded. “Thalamic and putaminal volumes are promising imaging biomarkers in MS.”

Sotirchos ES, Gonzalez-Caldito N, Dewey BE, Fitzgerald KC, Glaister et. Al. Effect of disease-modifying therapies on subcortical gray matter atrophy in multiple sclerosis. Mult Scler. 2019 Feb 11:1352458519826364. doi: 10.1177/1352458519826364. [Epub ahead of print] PubMed PMID: 30741108.

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