MRI Subclinical MS Disease Activity as a Surrogate of a Clinical Relapse

After initiating disease-modifying therapy (DMT) in multiple sclerosis (MS), assessment of treatment response is critical. Early disease activity increases the risk for later disability progression. The European Medicines Agency (EMA) clinical guidelines for prompt consideration of so-called second-line agents (i.e., natalizumab, fingolimod) include a clinical relapse in the year following DMT initiation, accompanied by either a contrast-enhancing lesion (CEL) or ≥9 T2 lesions at baseline. However, the impact of subclinical magnetic resonance imaging (MRI) lesions has not been addressed sufficiently.

Now, researchers have evaluated the relation between MRI lesion count thresholds during treatment year 1 and 4-year outcomes. A total of 370 pa…