title: Effect of disease-modifying drugs on cortical lesions and atrophy in relapsing-remitting multiple sclerosis.
abstract: OBJECTIVE
  To measure the effects of disease-modifying drugs (DMDs) on the development of cortical lesions (CL) and cortical atrophy in patients with relapsing-remitting multiple sclerosis (RRMS).
  
  
  METHODS
  RRMS patients (n = 165) were randomized to subcutaneous (sc) interferon (IFN) beta-1a (44 mcg three times weekly), intramuscular (im) IFN beta-1a (30 mcg weekly) or glatiramer acetate (GA; 20 mg daily). The reference population comprised 50 untreated patients. Clinical and MRI examinations were performed at baseline, 12 months and 24 months.
  
  
  RESULTS
  One hundred and forty-one treated patients completed the study. After 12 months, 37/50 (74%) of untreated patients developed ≥ 1 new CL (mean 1.6), compared with 30/47 (64%) of im IFN beta-1a-treated patients (mean 1.2, p = 0.021), 24/48 (50%) of GA-treated patients (mean 0.8, p = 0.001) and 12/46 (26%) of sc IFN beta-1a-treated patients (mean 0.4, p < 0.001). After 24 months, ≥ 1 new CL was observed in 41/50 (82%) of untreated (mean 3.0), 34/47 (72%) of im IFN beta-1a-treated (mean 1.6, p < 0.001), 30/48 (62%) of GA-treated (mean 1.3, p < 0.001) and 24/46 (52%) of sc IFN beta-1a-treated patients (mean 0.8, p < 0.001). Mean grey matter fraction decrease in DMD-treated patients at 24 months ranged from 0.7 to 0.8 versus 1.0 in untreated patients (p = 0.023).
  
  
  CONCLUSIONS
  Disease-modifying drugs significantly decreased new CL development and cortical atrophy progression compared with untreated patients, with faster and more pronounced effects seen with sc IFN beta-1a than with im IFN beta-1a or GA.
authors.affiliation: The Multiple Sclerosis Centre of the Veneto Region, Department of Neurology, University Hospital of Padova, Padova, Italy. calabresem@hotmail.it
authors.forename: M
authors.initials: M
authors.lastname: Calabrese
authors.forename: V
authors.initials: V
authors.lastname: Bernardi
authors.forename: M
authors.initials: M
authors.lastname: Atzori
authors.forename: I
authors.initials: I
authors.lastname: Mattisi
authors.forename: A
authors.initials: A
authors.lastname: Favaretto
authors.forename: F
authors.initials: F
authors.lastname: Rinaldi
authors.forename: P
authors.initials: P
authors.lastname: Perini
authors.forename: P
authors.initials: P
authors.lastname: Gallo
mesh_terms: D000293:Adolescent; D000328:Adult; D001284:Atrophy / Q000188:drug therapy; D002525:Cerebellar Cortex / Q000187:drug effects / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D000068717:Glatiramer Acetate; D006801:Humans; D007273:Injections, Intramuscular; D007279:Injections, Subcutaneous; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000008:administration & dosage / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000473:pathology*; D010455:Peptides / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010455:Peptides; D000068717:Glatiramer Acetate; D016899:Interferon-beta; D000068556:Interferon beta-1a