Quantitative MRI in patients with secondary progressive MS treated with monoclonal antibody Campath 1H
- 1 September 1999
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 53 (4), 751
- https://doi.org/10.1212/wnl.53.4.751
Abstract
Background: To assess the long-term effect of the lymphocyte-depleting humanized monoclonal antibody Campath 1H on MR markers of disease activity and progression in secondary progressive MS patients. Methods: Twenty-five patients participated in a crossover treatment trial with monthly run-in MR scans for 3 months, followed (after a single pulse of Campath 1H) by monthly MR scans from months 1 to 6 and again from months 12 to 18. MR analysis was performed to provide measurements of the number and volume of gadolinium (Gd)-enhancing lesions as well as the hypointense lesion volume on a T1-weighted sequence. In addition, serial measurements of T2 brain lesion volume, brain volume, and spinal cord cross-sectional area were made over the duration of the study. The relationship between clinical and MR measures of disease evolution was also assessed. Results: Treatment was associated with a reduction in the number and volume of Gd-enhancing lesions (p < 0.01). Despite this, a decrease in brain volume was seen in 13 patients during the 18 months post-treatment. The mean pretreatment Gd-enhancing lesion volume was predictive of subsequent reduction in brain volume (r = 0.77, p = 0.002). Reduction in brain volume also correlated with the change in T1 hypointense lesion volume after treatment (r = 0.53, p < 0.01). A reduction in spinal cord area was also seen throughout the study duration, and this correlated with an increase in disability (r = 0.65, p = 0.01). Conclusion: Campath 1H treatment was associated with a sustained and marked reduction in the volume of Gd enhancement, indicating suppression of active inflammation. Nevertheless, many patients developed increasing brain and spinal cord atrophy, T1 hypointensity, and disability. This study highlights the potential role for novel MR techniques in monitoring the effect of treatment on the pathologic process in MS.Keywords
This publication has 26 references indexed in Scilit:
- Pulsed monoclonal antibody treatment and autoimmune thyroid disease in multiple sclerosisThe Lancet, 1999
- Gadolinium enhanced MRI predicts clinical and MRI disease activity in relapsing-remitting multiple sclerosis.Journal of Neurology, Neurosurgery & Psychiatry, 1997
- A reproducible repositioning method for serial magnetic resonance imaging studies of the brain in treatment trials for multiple sclerosisJournal of Magnetic Resonance Imaging, 1997
- Progressive cerebral atrophy in multiple sclerosis A serial MRI studyBrain, 1996
- Magnetic resonance imaging changes with recombinant human interferon-beta-1a: a short term study in relapsing-remitting multiple sclerosis.Journal of Neurology, Neurosurgery & Psychiatry, 1996
- Spinal cord atrophy and disability in multiple sclerosisBrain, 1996
- Guidelines for the use of magnetic resonance techniques in monitoring the treatment of multiple sclerosisAnnals of Neurology, 1996
- The effect of interferon‐β on blood—brain barrier disruptions demonstrated by constrast‐enhanced magnetic resonance imaging in relapsing—remitting multiple sclerosisAnnals of Neurology, 1995
- Rating neurologic impairment in multiple sclerosisNeurology, 1983
- New diagnostic criteria for multiple sclerosis: Guidelines for research protocolsAnnals of Neurology, 1983