Which Patients with Progressive MS Benefit from Anti-Inflammatory Therapies?

Progressive multiple sclerosis (MS) remains challenging to treat, with younger and less disabled patients deriving more benefit. In this individual-patient data meta-analysis of 4485 participants from six placebo-controlled trials, researchers assessed whether baseline lesion activity modulates treatment effect on confirmed disability worsening (CDW) and whether lesion reduction mediates this effect.

• Among nearly 1000 patients with baseline lesion activity, treated patients had significantly reduced CDW risk, while some 3500 patients without active disease had no significant benefit when treated.

• In 719 patients with active disease and MRI data, decreased lesion activity mediated more than half of the treatment effect on disability.