Acute Clinical Events Identified as Relapses With Stable Magnetic Resonance Imaging in Multiple Sclerosis
- Type de publi. : Article dans une revue
- Date de publi. : 01/07/2024
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Auteurs :
Antoine GavoilleFabien RollotRomain CaseyAnne KerbratAnne KerbratEmmanuelle Le PageKevin BigautGuillaume MatheyGuillaume MatheyLaure MichelJonathan CironAurelie RuetEdouard JanuelPierre LabaugeHélène ZéphirCaroline PapeixGilles DeferChristine Lebrun-FrénayThibault MoreauEric BergerBruno StankoffPierre ClavelouEric ThouvenotOlivier HeinzlefJean PelletierAbdullatif Al-KhedrOlivier CasezBertrand BourrePhilippe CabreAbir WahabLaurent MagyJean-Philippe CamdessanchéInès DoghriSolène MoulinHaifa Ben-NasrCéline LabeyrieCéline LabeyrieKarolina HankiewiczJean-Philippe NeauCorinne PottierChantal NifleEric ManchonBertrand LapergueS WiertlewskiJérôme de SèzeSandra VukusicDavid-Axel LaplaudFrançois CottonPascal DouekF. GuilleminAlexandre PachotJavier OlaizClaire Rigaud-BullyRomain MarignierDamien BiottiJean-Christophe OualletNicolas CollonguesOlivier OutteryckXavier MoissetNathalie DeracheMikael CohenAgnès FromontSandrine WiertlewskyMatthieu BereauBertrand AudoinClaire GiannesiniCaroline BensaGiovanni CastelnovoOmbeline FagniezBenjamin HebantMathieu VaillantSéverine JeaninAlain CréangeJean-Michel VallatPhilippe ConversStéphane BeltranCarole HenryMarie CamuzeauxMaryline DelattreLaura TrottaCatherine GirodAmandine Ostermann-ZieglerDamien Le PortNoellie FreitasCarole BertheKaty-Kim LatasteKarima ZehrouniFrédéric PinnaJulie PetitSadou Safa DialloKarine DroulonCéline CallierAlexia ProtinMelinda MoyonChrystelle CappeEmilie DumontHanane AgherbiMarie BlanchereMarie-Pierre RanjevaAmandine da VeigaMaty Diop KaneChristine VimontMarjory CayolSafiyatou BaldeDaisy RousseauKarine FerraudGéraldine MeunierElise VarnierEdwige LescieuxHalima BourenaneStéphanie CossecÉmilie RaboisLynda BenammarAnaïs Beulaygue
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Organismes :
Université de Lyon
Hospices Civils de Lyon
Laboratoire de Biométrie et Biologie Evolutive - UMR 5558
Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Centre d'Investigation Clinique [Rennes]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Centre d'Investigation Clinique [Rennes]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Centre d'Investigation Clinique [Rennes]
Service de Neurologie [Strasbourg]
CIC Strasbourg
Service de neurologie [CHRU Nancy]
Adaptation, mesure et évaluation en santé. Approches interdisciplinaires
Service de neurologie [CHRU Nancy]
Adaptation, mesure et évaluation en santé. Approches interdisciplinaires
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Centre d'Investigation Clinique [Rennes]
Passages XX-XXI
Institut Toulousain des Maladies Infectieuses et Inflammatoires
Centre Ressources et Compétences sclérose en plaques (CRC-SEP) [CHU Toulouse]
Centre Hospitalier Universitaire de Bordeaux
Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale
CHU Pitié-Salpêtrière [AP-HP]
CHU Montpellier = Montpellier University Hospital
Université de Montpellier
Lille Neurosciences & Cognition - U 1172
Centre Hospitalier Régional Universitaire [CHU Lille]
Hôpital Fondation Adolphe de Rothschild = Adolphe de Rothschild Foundation Hospital
CHU Caen Normandie – Centre Hospitalier Universitaire de Caen Normandie
Centre Hospitalier Universitaire de Nice
Unité de Recherche Clinique Côte d’Azur
Université Côte d'Azur
Service de Neurologie générale, vasculaire et dégénérative (CHU de Dijon)
Service de Neurologie [CHRU Besançon]
Institut du Cerveau = Paris Brain Institute
Service Neurologie [CHU Clermont-Ferrand]
Neuro-Dol
Neuro-Dol
Centre Hospitalier Universitaire de Nîmes
Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy]
Hôpital de la Timone [CHU - APHM]
Service de neurologie [Amiens]
Centre Hospitalier Universitaire [CHU Grenoble]
Translational Research in Autoimmunity and Inflammation Group
Service de neurologie [Rouen]
Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique]
CHU Henri Mondor [Créteil]
Hôpital Dupuytren [CHU Limoges]
Service de Neurologie [CHU de Saint-Étienne]
Centre Hospitalier Régional Universitaire de Tours
Hôpital universitaire Robert Debré [Reims]
Centre Hospitalier Sud Francilien
Service de neurologie [Le Kremlin Bicêtre]
Service de neurologie [Le Kremlin Bicêtre]
Groupe Hospitalier Universitaire Paris Seine-Saint-Denis
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
Centre Hospitalier René Dubos [Pontoise]
Centre Hospitalier de Versailles André Mignot
Centre Hospitalier de Gonesse
Hôpital Foch [Suresnes]
Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
Centre d’Investigation Clinique de Nantes
CIC Strasbourg
Service de Neurologie [Lyon]
Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
Fondation Eugène Devic EDMUS
Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
Centre d’Investigation Clinique de Nantes
Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
Forgetting Processes and Cortical Dynamics
Plateforme de Neurobiologie Moléculaire, Cellulaire et Tissulaire
Hospices Civils de Lyon
Université Claude Bernard Lyon 1
Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle
- Publié dans JAMA neurology le 24/10/2020
Résumé : Importance: Understanding the association between clinically defined relapses and radiological activity in multiple sclerosis (MS) is essential for patient treatment and therapeutic development. Objective: To investigate clinical events identified as relapses but not associated with new T2 lesions or gadolinium-enhanced T1 lesions on brain and spinal cord magnetic resonance imaging (MRI). Design, setting, and participants: This multicenter observational cohort study was conducted between January 2015 and June 2023. Data were extracted on June 8, 2023, from the French MS registry. All clinical events reported as relapses in patients with relapsing-remitting MS were included if brain and spinal cord MRI was performed within 12 and 24 months before the event, respectively, and 50 days thereafter with gadolinium injection. Exposures: Events were classified as relapses with active MRI (RAM) if a new T2 lesion or gadolinium-enhanced T1 lesion appeared on brain or spinal cord MRI or as acute clinical events with stable MRI (ACES) otherwise. Main outcomes and measures: Factors associated with ACES were investigated; patients with ACES and RAM were compared regarding Expanded Disability Status Scale (EDSS) course, relapse rate, confirmed disability accrual (CDA), relapse-associated worsening (RAW), progression independent of relapse activity (PIRA), and transition to secondary progressive (SP) MS, and ACES and RAM rates under each disease-modifying therapy (DMT) were estimated. Results: Among 31 885 clinical events, 637 in 608 patients (493 [77.4%] female; mean [SD] age, 35.8 [10.7] years) were included. ACES accounted for 166 (26.1%) events and were more likely in patients receiving highly effective DMTs, those with longer disease duration (odds ratio [OR], 1.04; 95% CI, 1.01-1.07), or those presenting with fatigue (OR, 2.14; 95% CI, 1.15-3.96). ACES were associated with significant EDSS score increases, lower than those found for RAM. Before the index event, patients with ACES experienced significantly higher rates of relapse (relative rate [RR], 1.21; 95% CI, 1.01-1.46), CDA (hazard ratio [HR], 1.54; 95% CI, 1.13-2.11), and RAW (HR, 1.72; 95% CI, 1.20-2.45). Patients with ACES were at significantly greater risk of SP transition (HR, 2.58; 95% CI, 1.02-6.51). Although RAM rate decreased with DMTs according to their expected efficacy, ACES rate was stable across DMTs. Conclusions and relevance: The findings in this study introduce the concept of ACES in MS, which accounted for one-fourth of clinical events identified as relapses.
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