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Effect of copolymer-1 on serial gadolinium-enhanced MRI in relapsing remitting multiple sclerosis
G L Mancardi1, F Sardanelli, R C Parodi
1Department of Neurological Sciences, University of Genoa, Italy.
Abstract:
We examined the effect of Copolymer-1 (Cop1) on magnetic resonance (MR) imaging changes in 10 patients with relapsing-remitting multiple sclerosis (RRMS). Monthly gadolinium (Gd)-enhanced MR imaging was performed for 9 to 27 months in the pretreatment period followed by 10 to 14 additional months during Cop1 treatment. MR images were evaluated by two radiologists (F.S. and R.C.P.) masked to the scan date. We found a 57% decrease in the frequency of new Gd-enhancing lesions and in the mean area/month of new Gd-enhancing lesions in the Cop1 treatment period compared with the pretreatment period (0.92 versus 2.20 lesions per month and 22 mm2 versus 43 mm2 area/month; p = 0.1, Wilcoxon signed rank test). Percentage change in lesion load area on T2-weighted images showed a decrease in the accumulation of lesion area during treatment, which was significant for the patient group with a longer pretreatment period (p = 0.05, Friedman test). These results demonstrate a reduction in the number of new Gd-enhancing lesions and in the lesion load during Cop1 treatment compared with the preceding period without therapy and are suggestive of an effect of Cop1 on MR abnormalities observed in multiple sclerosis.
Insights
Copolymer-1 (Cop1) treatment significantly reduced new gadolinium-enhancing lesions in multiple sclerosis patients. This therapy also decreased overall lesion load, suggesting Cop1 impacts MRI-visible disease activity.
Area of Science:
- Neuroimmunology
- Radiology
- Clinical Neurology
Background:
- Multiple Sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
- Relapsing-remitting MS (RRMS) is characterized by distinct neurological episodes followed by recovery.
- Magnetic Resonance (MR) imaging, particularly with gadolinium (Gd) enhancement, is crucial for monitoring MS disease activity.
Purpose of the Study:
- To evaluate the effect of Copolymer-1 (Cop1) on MR imaging metrics in patients with RRMS.
- To assess changes in Gd-enhancing lesions and overall lesion load during Cop1 therapy.
Main Methods:
- Prospective study involving 10 RRMS patients.
- Monthly Gd-enhanced MR imaging before and during Cop1 treatment (9-27 months pretreatment, 10-14 months treatment).
- Independent, masked radiologist evaluation of MR images.
Main Results:
- A 57% decrease in the frequency of new Gd-enhancing lesions during Cop1 treatment compared to pretreatment (0.92 vs 2.20 lesions/month).
- A significant reduction in the mean area/month of new Gd-enhancing lesions (22 mm2 vs 43 mm2).
- A decrease in lesion load accumulation on T2-weighted images during Cop1 treatment, significant in patients with longer pretreatment periods (p=0.05).
Conclusions:
- Copolymer-1 treatment is associated with a reduction in new Gd-enhancing lesions and overall lesion load in RRMS patients.
- These findings suggest Cop1 has a beneficial effect on MR-detectable disease activity in multiple sclerosis.
- Cop1 may modulate the inflammatory processes underlying MS lesion formation.