Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study

Kuhle, J. and Disanto, G. and Dobson, R. and Adiutori, R. and Bianchi, L. and Topping, J. and Bestwick, J. P. and Meier, U. C. and Marta, M. and Dalla Costa, G. and Runia, T. and Evdoshenko, E. and Lazareva, N. and Thouvenot, E. and Iaffaldano, P. and Direnzo, V. and Khademi, M. and Piehl, F. and Comabella, M. and Sombekke, M. and Killestein, J. and Hegen, H. and Rauch, S. and D'Alfonso, S. and Alvarez-Cermeno, J. C. and Kleinova, P. and Horakova, D. and Roesler, R. and Lauda, F. and Llufriu, S. and Avsar, T. and Uygunoglu, U. and Altintas, A. and Saip, S. and Menge, T. and Rajda, C. and Bergamaschi, R. and Moll, N. and Khalil, M. and Marignier, R. and Dujmovic, I. and Larsson, H. and Malmestrom, C. and Scarpini, E. and Fenoglio, C. and Wergeland, S. and Laroni, A. and Annibali, V. and Romano, S. and Martinez, A. D. and Carra, A. and Salvetti, M. and Uccelli, A. and Torkildsen, O. and Myhr, K. M. and Galimberti, D. and Rejdak, K. and Lycke, J. and Frederiksen, J. L. and Drulovic, J. and Confavreux, C. and Brassat, D. and Enzinger, C. and Fuchs, S. and Bosca, I. and Pelletier, J. and Picard, C. and Colombo, E. and Franciotta, D. and Derfuss, T. and Lindberg, R. and Yaldizli, O. and Vecsei, L. and Kieseier, B. C. and Hartung, H. P. and Villoslada, P. and Siva, A. and Saiz, A. and Tumani, H. and Havrdova, E. and Villar, L. M. and Leone, M. and Barizzone, N. and Deisenhammer, F. and Teunissen, C. and Montalban, X. and Tintore, M. and Olsson, T. and Trojano, M. and Lehmann, S. and Castelnovo, G. and Lapin, S. and Hintzen, R. and Kappos, L. and Furlan, R. and Martinelli, V. and Comi, G. and Ramagopalan, S. V. and Giovannoni, G.. (2015) Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study. Multiple Sclerosis Journal, 21 (8). pp. 1013-1024.

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Official URL: https://edoc.unibas.ch/61679/

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Abstract

BACKGROUND AND OBJECTIVE: We explored which clinical and biochemical variables predict conversion from clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS) in a large international cohort. METHODS: Thirty-three centres provided serum samples from 1047 CIS cases with at least two years' follow-up. Age, sex, clinical presentation, T2-hyperintense lesions, cerebrospinal fluid (CSF) oligoclonal bands (OCBs), CSF IgG index, CSF cell count, serum 25-hydroxyvitamin D3 (25-OH-D), cotinine and IgG titres against Epstein-Barr nuclear antigen 1 (EBNA-1) and cytomegalovirus were tested for association with risk of CDMS. RESULTS: At median follow-up of 4.31 years, 623 CIS cases converted to CDMS. Predictors of conversion in multivariable analyses were OCB (HR = 2.18, 95% CI = 1.71-2.77, p 9 lesions vs 0/1 lesions: HR = 2.74, 95% CI = 2.04-3.68, p > 0.001) and age at CIS (HR per year inversely increase = 0.98, 95% CI = 0.98-0.99, p > 0.001). Lower 25-OH-D levels were associated with CDMS in univariable analysis, but this was attenuated in the multivariable model. OCB positivity was associated with higher EBNA-1 IgG titres. CONCLUSIONS: We validated MRI lesion load, OCB and age at CIS as the strongest independent predictors of conversion to CDMS in this multicentre setting. A role for vitamin D is suggested but requires further investigation.

Faculties and Departments:	03 Faculty of Medicine > Departement Biomedizin > Department of Biomedicine, University Hospital Basel > Clinical Neuroimmunology (Derfuss/Lindberg)
UniBasel Contributors:	Derfuss, Tobias Johannes
Item Type:	Article, refereed
Article Subtype:	Research Article
Publisher:	Sage Publications
ISSN:	1352-4585
e-ISSN:	1477-0970
Note:	Publication type according to Uni Basel Research Database: Journal article
Identification Number:	doi: 10.1177/1352458514568827 pmid: 25680984
Last Modified:	13 Nov 2018 19:06
Deposited On:	13 Nov 2018 19:06

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