title: Brain atrophy as a non-response predictor to interferon-beta in relapsing-remitting multiple sclerosis.
abstract: BACKGROUND
  Several predictors for treatment failure to interferon-beta (IFN-beta) have been proposed; however, brain atrophy has not been well studied.
  
  
  METHODS
  In this prospective and longitudinal study, all consecutive relapsing-remitting multiple sclerosis (RRMS) patients treated with sc IFN-beta-1a were included. Confirmed disability progression or a new relapse between weeks 48 and 144 after beginning with IFN-beta was considered as treatment non-response. EDSS progression, relapses, number of active lesions at 1 year (new or enlarging T2-weighted plus gadolinium-enhancing lesions, categorized in > 2 or ≤ 2), and brain parenchymal fraction (%BVC) volume change within the initial year of treatment were used as predictive factors. Cox regression model was adjusted for age, gender, and disease duration.
  
  
  RESULTS
  Seventy-one patients were included (71·8% female) with a follow-up of 144 weeks. Thirty-four (48%) fulfilled criteria of non-response to IFN-beta treatment. The model showed: (1) relapses+disability progression: HR  =  4·6, 95% IC: 3·1-6·7 (P < 0·001); (2) relapses+BVC decrease: HR  =  4·1, 95% IC: 3·2-7·3 (P  =  0·001); (3) relapses+disability progression+new active lesions: HR  =  10·1, 95% IC: 7·1-15·2 (P < 0·001); and (4) relapses+disability progression+new active lesions+BVC decrease: HR  =  14·4, 95% IC: 11·4-21·2 (P < 0·001).
  
  
  CONCLUSIONS
  Adding BVC measures to previously described predictive failure factors may increase sensitivity to early identify non-responder patients to IFN-beta-1a in the second and third years of therapy.
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Rojas
authors.forename: Liliana
authors.initials: L
authors.lastname: Patrucco
authors.forename: Jimena
authors.initials: J
authors.lastname: Miguez
authors.forename: Cristina
authors.initials: C
authors.lastname: Besada
authors.forename: Edgardo
authors.initials: E
authors.lastname: Cristiano
mesh_terms: D000328:Adult; D001284:Atrophy; D001921:Brain / Q000187:drug effects / Q000473:pathology*; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D016899:Interferon-beta / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000473:pathology*; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D012680:Sensitivity and Specificity; D017211:Treatment Failure
chemical_list: D007155:Immunologic Factors; D016899:Interferon-beta
keywords: Brain atrophy,; Interferon,; MR,; Multiple sclerosis,; Response