title: Prediction of disability progression in fingolimod-treated patients.
abstract: OBJECTIVE
  The aim of the study was to evaluate whether early disease activity during fingolimod treatment could predict disease progression in patients with relapsing-remitting multiple sclerosis (RRMS).
  
  
  METHODS
  We included RRMS patients who received fingolimod for at least 12 months with a ≥36 months of follow-up. Early disease activity was assessed by the modified Rio score (MRS). Association between MRS at 12 months and time to disability progression over the following two years was assessed using Kaplan-Meier survival curves analysis and Cox proportional hazards model.
  
  
  RESULTS
  At 1 year from starting treatment, 14 (58.3%), 5 (20.8%), 3 (12.5%) and 2 (8.3%) subjects had a MRS=0, 1, 2, and 3, respectively. The risk of disability progression in the next 2 years was associated to the MRS and increased from 21.1% in patients with MRS=0-1 to 80% in those with MRS≥2 (adjusted HR=19.67; 95% CI=2.30-167.79; p=0.006).
  
  
  CONCLUSIONS
  Early disease activity is suggested to be associated with the risk of disease progression in patients receiving fingolimod and MRS could be a reliable tool to identify the subjects at higher risk of unfavorable course.
authors.affiliation: Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, 60020 Ancona, Italy. Electronic address: alfierelattanzisimona@gmail.com.
authors.forename: Simona
authors.initials: S
authors.lastname: Lattanzi
authors.affiliation: Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, 60020 Ancona, Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Danni
authors.affiliation: Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, 60020 Ancona, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Cerqua
authors.affiliation: Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, 60020 Ancona, Italy.
authors.forename: Ruja
authors.initials: R
authors.lastname: Taffi
authors.affiliation: Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, 60020 Ancona, Italy.
authors.forename: Leandro
authors.initials: L
authors.lastname: Provinciali
authors.affiliation: Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, 60020 Ancona, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Silvestrini
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D000068876:Fingolimod Hydrochloride / Q000008:administration & dosage / Q000494:pharmacology*; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000503:physiopathology*; D017063:Outcome Assessment, Health Care; D011379:Prognosis
chemical_list: D007166:Immunosuppressive Agents; D000068876:Fingolimod Hydrochloride
keywords: Disability; Disease-modifying drug; Fingolimod; Multiple sclerosis; Relapsing–remitting; Treatment response