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Kuhle, J; Disanto, G; Dobson, R; Adiutori, R; Bianchi, L; Topping, J; Bestwick, JP; Meier, U-C; Marta, M; Costa, G Dalla; Runia, T; Evdoshenko, E; Lazareva, N; Thouvenot, E; Iaffaldano, P; Direnzo, V; Khademi, M; Piehl, F; Comabella, M; Sombekke, M; Killestein, J; Hegen, H; Rauch, S; D’Alfonso, S; [...]

Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study

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  • Medientyp: E-Artikel
  • Titel: Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study
  • Beteiligte: Kuhle, J; Disanto, G; Dobson, R; Adiutori, R; Bianchi, L; Topping, J; Bestwick, JP; Meier, U-C; Marta, M; Costa, G Dalla; Runia, T; Evdoshenko, E; Lazareva, N; Thouvenot, E; Iaffaldano, P; Direnzo, V; Khademi, M; Piehl, F; Comabella, M; Sombekke, M; Killestein, J; Hegen, H; Rauch, S; D’Alfonso, S; [...]
  • Erschienen: SAGE Publications, 2015
  • Erschienen in: Multiple Sclerosis Journal
  • Sprache: Englisch
  • DOI: 10.1177/1352458514568827
  • ISSN: 1352-4585; 1477-0970
  • Schlagwörter: Neurology (clinical) ; Neurology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec><jats:title>Background and objective:</jats:title><jats:p> We explored which clinical and biochemical variables predict conversion from clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS) in a large international cohort. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> Thirty-three centres provided serum samples from 1047 CIS cases with at least two years’ follow-up. Age, sex, clinical presentation, T2-hyperintense lesions, cerebrospinal fluid (CSF) oligoclonal bands (OCBs), CSF IgG index, CSF cell count, serum 25-hydroxyvitamin D3 (25-OH-D), cotinine and IgG titres against Epstein-Barr nuclear antigen 1 (EBNA-1) and cytomegalovirus were tested for association with risk of CDMS. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> At median follow-up of 4.31 years, 623 CIS cases converted to CDMS. Predictors of conversion in multivariable analyses were OCB (HR = 2.18, 95% CI = 1.71–2.77, p &lt; 0.001), number of T2 lesions (two to nine lesions vs 0/1 lesions: HR = 1.97, 95% CI = 1.52–2.55, p &lt; 0.001; &gt;9 lesions vs 0/1 lesions: HR = 2.74, 95% CI = 2.04–3.68, p &lt; 0.001) and age at CIS (HR per year inversely increase = 0.98, 95% CI = 0.98–0.99, p &lt; 0.001). Lower 25-OH-D levels were associated with CDMS in univariable analysis, but this was attenuated in the multivariable model. OCB positivity was associated with higher EBNA-1 IgG titres. </jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p> We validated MRI lesion load, OCB and age at CIS as the strongest independent predictors of conversion to CDMS in this multicentre setting. A role for vitamin D is suggested but requires further investigation. </jats:p></jats:sec>