Steroids may reduce the short-term confounding effects of pseudoatrophy, which has implications for clinical trials but not yet for clinical practice.
Spinal cord atrophy is a key imaging biomarker in multiple sclerosis (MS), but early volume loss after the initiation of disease-modifying therapy (DMT) may reflect pseudoatrophy due to reduction of inflammation and edema, rather than true neurodegeneration. Can administering high-dose glucocorticoids (HDG) before DMT initiation modify pseudoatrophy?
To assess this, researchers retrospectively analyzed data from 102 patients participating in a prospective cohort study. All of the patients had MRIs performed before starting DMT for newly diagnosed MS; 42 of them received HDG before the MRI, and 60 did not. Volume changes in the spinal cord and brain were monitored over 2 years.
The key findings:
Reviewing Author
DisclosuresConsultant/Advisory BoardAlexion Pharmaceuticals; Amgen; Astoria; Biogen; Bristol Myers Squibb; Celltrion; Genentech; Hoffmann-La Roche; Genzyme; EMD Serono; Immpact-Bio; Immunic Therapeutics; Kyverna; Lundbeck; Novartis; Sandoz; TG Therapeutics
Grant/Research SupportNational Institutes of Health; National Multiple Sclerosis Society; U.S. Department of Defense
Leadership Positions in Professional SocietiesConsortium of Multiple Sclerosis Centers (Treasurer)
DisclosuresConsultant/Advisory BoardAlexion Pharmaceuticals; Amgen; Astoria; Biogen; Bristol Myers Squibb; Celltrion; Genentech; Hoffmann-La Roche; Genzyme; EMD Serono; Immpact-Bio; Immunic Therapeutics; Kyverna; Lundbeck; Novartis; Sandoz; TG Therapeutics
Grant/Research SupportNational Institutes of Health; National Multiple Sclerosis Society; U.S. Department of Defense
Leadership Positions in Professional SocietiesConsortium of Multiple Sclerosis Centers (Treasurer)