title: Assessing treatment response to interferon-β: is there a role for MRI?
abstract: OBJECTIVE
  Interferon-β (IFN-β) has been shown to reduce relapse rates in multiple sclerosis; however, the clinical response appears to vary among individuals. Can early MRI be used to identify those patients who have a poor response to treatment?
  
  
  METHODS
  A systematic review of studies examining differential treatment response and clinical endpoints in groups defined as responders or nonresponders to IFN-β was performed. Meta-analytic techniques were used to combine study results where appropriate.
  
  
  RESULTS
  Patients with MRI evidence of poor response to IFN-β treatment as defined by either ≥2 new hyperintense T2 lesions or new gadolinium-enhancing lesions had significantly increased risk of both future relapses and progression as defined by the Expanded Disability Status Scale. There appeared to be an increased risk of poor outcomes 16 years after treatment initiation in those with an initial poor response to treatment. Previous evidence has shown this not to be the case in placebo arms of clinical trials.
  
  
  CONCLUSIONS
  For those patients starting IFN-β, early MRI, within 6 to 24 months after starting treatment, has the potential to provide important information when counseling patients about the likelihood of future treatment failure. This can inform treatment decisions before clinical relapses or disease progression.
authors: From the Queen Mary University London (R.D., K.S., G.G.), Blizard Institute, UK; Neurological Institute (R.A.R.), Mellen Center for MS Treatment and Research, Cleveland, OH; and Royal London Hospital (R.D., B.T., K.S., G.G.), Barts Health NHS Trust, UK.
authors: Ruth
authors: R
authors: Dobson
authors: Richard A
authors: RA
authors: Rudick
authors: Ben
authors: B
authors: Turner
authors: Klaus
authors: K
authors: Schmierer
authors: Gavin
authors: G
authors: Giovannoni
mesh_terms: D002986:Clinical Trials as Topic / Q000639:trends; D006801:Humans; D016899:Interferon-beta / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009103:Multiple Sclerosis / Q000188:drug therapy*; D011237:Predictive Value of Tests; D017211:Treatment Failure
chemical_list: D016899:Interferon-beta