Background:There is emerging evidence that intrathecal IgM synthesis (ITMS) is a risk factor for conversion to clinically defined multiple sclerosis (CDMS) in clinically isolated syndrome (CIS) patients.Objectives:The objective of this study is to verify the prognostic role of ITMS as a risk factor for the second clinical attack in patients after the first demyelinating event.Methods:Monocentric observational study performed on prospectively acquired clinical data and retrospective evaluation of magnetic resonance imaging (MRI) data. ITMS was assessed according to Reiber's non-linear function. We compared time to the second attack by using Kaplan-Meier curves and performed adjustment by Cox regression analysis.Results:Demographics and clinical data were collected prospectively in a cohort of 68 patients. ITMS occurred in 40% (27/68) of patients who had a higher T1-hypointense lesion load at brain MRI (p = 0.041). In multivariate Cox regression analysis (adjusted for age, sex, baseline Expanded Disability Status Scale, IgG oligoclonal bands and disease-modifying treatment exposure), relapsing-remitting multiple sclerosis (MS) patients with ITMS were at higher risk to experience a second clinical attack (adjusted hazard ratio (aHR) = 6.3, 95% confidence interval (CI) = 2.1-18.4, p = 0.001).Conclusion:Together with previous studies, our findings support the role of ITMS as a prognostic biomarker in MS.

Prognostic role of intrathecal IgM synthesis in multiple sclerosis: Results from a clinical series / Fonderico, Mattia; Biagioli, Tiziana; Lanzilao, Luisa; Bellinvia, Angelo; Fratangelo, Roberto; Pastò, Luisa; Prestipino, Elio; Razzolini, Lorenzo; Tudisco, Laura; Ginestroni, Andrea; Vuolo, Luisa; Fainardi, Enrico; Ballerini, Clara; Portaccio, Emilio; Amato, Maria Pia. - In: MULTIPLE SCLEROSIS. - ISSN 1352-4585. - ELETTRONICO. - (2021), pp. 198-207. [10.1177/1352458520907913]

Prognostic role of intrathecal IgM synthesis in multiple sclerosis: Results from a clinical series

Fonderico, Mattia;Biagioli, Tiziana;Lanzilao, Luisa;Bellinvia, Angelo;Fratangelo, Roberto;Prestipino, Elio;Razzolini, Lorenzo;Tudisco, Laura;Ginestroni, Andrea;Vuolo, Luisa;Fainardi, Enrico;Ballerini, Clara;Portaccio, Emilio;Amato, Maria Pia
2021

Abstract

Background:There is emerging evidence that intrathecal IgM synthesis (ITMS) is a risk factor for conversion to clinically defined multiple sclerosis (CDMS) in clinically isolated syndrome (CIS) patients.Objectives:The objective of this study is to verify the prognostic role of ITMS as a risk factor for the second clinical attack in patients after the first demyelinating event.Methods:Monocentric observational study performed on prospectively acquired clinical data and retrospective evaluation of magnetic resonance imaging (MRI) data. ITMS was assessed according to Reiber's non-linear function. We compared time to the second attack by using Kaplan-Meier curves and performed adjustment by Cox regression analysis.Results:Demographics and clinical data were collected prospectively in a cohort of 68 patients. ITMS occurred in 40% (27/68) of patients who had a higher T1-hypointense lesion load at brain MRI (p = 0.041). In multivariate Cox regression analysis (adjusted for age, sex, baseline Expanded Disability Status Scale, IgG oligoclonal bands and disease-modifying treatment exposure), relapsing-remitting multiple sclerosis (MS) patients with ITMS were at higher risk to experience a second clinical attack (adjusted hazard ratio (aHR) = 6.3, 95% confidence interval (CI) = 2.1-18.4, p = 0.001).Conclusion:Together with previous studies, our findings support the role of ITMS as a prognostic biomarker in MS.
2021
198
207
Fonderico, Mattia; Biagioli, Tiziana; Lanzilao, Luisa; Bellinvia, Angelo; Fratangelo, Roberto; Pastò, Luisa; Prestipino, Elio; Razzolini, Lorenzo; Tud...espandi
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1187836
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