Prediction of on-treatment disability worsening in RRMS with the MAGNIMS score

Amy Kunchok, Jeannette Lechner-Scott, Franco Granella, Maria Trojano, Raed Alroughani, Patrizia Sola, Diana Ferraro, Alessandra Lugaresi, Marco Onofrj, Serkan Ozakbas, Guillermo Izquierdo, Pierre Grammond, Jose Luis Sanchez-Menoyo, Bart Van Wijmeersch, Cavit Boz, Eugenio Pucci, Pamela McCombe, Francois Grand’Maison, Daniele Spitaleri, Steve VucicRaymond Hupperts, Vilija Jokubaitis, Maria Pia Sormani, Helmut Butzkueven, Tomas Kalincik, for the MSBase Study Group

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7 Citations (Scopus)


Background: The magnetic resonance imaging in multiple sclerosis (MAGNIMS) score combines relapses and magnetic resonance imaging (MRI) lesions to predict disability outcomes in relapsing–remitting multiple sclerosis (RRMS) treated with interferon-β. Objective: To validate the MAGNIMS score and extend to other disease-modifying therapies (DMTs). To examine the prognostic value of gadolinium contrast-enhancing (Gd+) lesions. Methods: This RRMS MSBase cohort study (n = 2293) used a Cox model to examine the prognostic value of relapses, MRI activity and the MAGNIMS score for disability worsening during treatment with interferon-β and three other DMTs. Results: Three new T2 lesions (hazard ratio (HR) = 1.60, p = 0.028) or two relapses (HR = 2.24, p = 0.002) on interferon-β (for 12 months) were predictive of disability worsening over 4 years. MAGNIMS score = 2 (1 relapse and ⩾3 T2 lesions or ⩾2 relapses) was associated with a greater risk of disability worsening on interferon-β (HR = 2.0, p = 0.001). In pooled cohort of four DMTs, similar associations were seen (MAGNIMS score = 2: HR = 1.72, p = 0.001). Secondary analyses demonstrated that the addition of Gd+ to the MAGNIMS did not materially improve its prediction of disability worsening. Conclusion: We have validated the MAGNIMS score in RRMS and extended its application to three other DMTs: 1 relapse and ⩾3 T2 lesions or ⩾2 relapses predicted worsening of disability. Contrast-enhancing lesions did not substantially improve the prognostic score.

Original languageEnglish
Pages (from-to)695-705
Number of pages11
JournalMultiple Sclerosis Journal
Issue number5
Publication statusPublished - Apr 2021


  • magnetic resonance imaging
  • Multiple sclerosis
  • outcomes
  • prediction
  • prognosis
  • therapy

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