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

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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
Number of pages11
JournalMultiple Sclerosis Journal
DOIs
Publication statusAccepted/In press - 8 Jul 2020

Keywords

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

Cite this

Kunchok, A., Lechner-Scott, J., Granella, F., Trojano, M., Alroughani, R., Sola, P., Ferraro, D., Lugaresi, A., Onofrj, M., Ozakbas, S., Izquierdo, G., Grammond, P., Luis Sanchez-Menoyo, J., Van Wijmeersch, B., Boz, C., Pucci, E., McCombe, P., Grand’Maison, F., Spitaleri, D., ... for the MSBase Study Group (Accepted/In press). Prediction of on-treatment disability worsening in RRMS with the MAGNIMS score. Multiple Sclerosis Journal. https://doi.org/10.1177/1352458520936823