Gabriel Bsteh, Harald Hegen, Nik Krajnc, Fabian Föttinger, Patrick Altmann, Michael Auer, Klaus Berek, Barbara Kornek, Fritz Leutmezer, Stefan Macher, Tobias Monschein, Markus Ponleitner, Paulus Rommer, Christiane Schmied, Karin Zebenholzer, Gudrun Zulehner, Tobias Zrzavy, Florian Deisenhammer, Franziska Di Pauli, Berthold Pemp, Thomas Berger
{"title":"用于监测复发性多发性硬化症病情改变治疗的视网膜层变薄--应用 \"重塑 \"概念的证据。","authors":"Gabriel Bsteh, Harald Hegen, Nik Krajnc, Fabian Föttinger, Patrick Altmann, Michael Auer, Klaus Berek, Barbara Kornek, Fritz Leutmezer, Stefan Macher, Tobias Monschein, Markus Ponleitner, Paulus Rommer, Christiane Schmied, Karin Zebenholzer, Gudrun Zulehner, Tobias Zrzavy, Florian Deisenhammer, Franziska Di Pauli, Berthold Pemp, Thomas Berger","doi":"10.1177/13524585241267257","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Employing a rebaselining concept may reduce noise in retinal layer thinning measured by optical coherence tomography (OCT).</p><p><strong>Methods: </strong>From an ongoing prospective observational study, we included patients with relapsing multiple sclerosis (RMS), who had OCT scans at disease-modifying treatment (DMT) start (baseline), 6-12 months after baseline (rebaseline), and ⩾12 months after rebaseline. Mean annualized percent loss (aL) rates (%/year) were calculated both from baseline and rebaseline for peripapillary-retinal-nerve-fiber-layer (aLpRNFL<sub>baseline</sub>/aLpRNFL<sub>rebaseline</sub>) and macular-ganglion-cell-plus-inner-plexiform-layer (aLGCIPL<sub>baseline</sub>/aLGCIPL<sub>rebaseline</sub>) by mixed-effects linear regression models.</p><p><strong>Results: </strong>We included 173 RMS patients (mean age 31.7 years (SD 8.8), 72.8% female, median disease duration 15 months (12-94) median baseline-to-last-follow-up-interval 37 months (18-71); 56.6% moderately effective DMT (M-DMT), 43.4% highly effective DMT (HE-DMT)). Both mean aLpRNFL<sub>baseline</sub> and aLGCIPL<sub>baseline</sub> significantly increased in association with relapse (0.51% and 0.26% per relapse, <i>p</i> < 0.001, respectively) and disability worsening (1.10% and 0.48%, <i>p</i> < 0.001, respectively) before baseline, but not with DMT class. Contrarily, neither aLpRNFL<sub>rebaseline</sub> nor aLGCIPL<sub>rebaseline</sub> was dependent on relapse or disability worsening before baseline, while HE-DMT significantly lowered aLpRNFL<sub>rebaseline</sub> (by 0.31%, <i>p</i> < 0.001) and aLGCIPL<sub>rebaseline</sub> (0.25%, <i>p</i> < 0.001) compared with M-DMT.</p><p><strong>Conclusions: </strong>Applying a rebaselining concept significantly improves differentiation of DMT effects on retinal layer thinning by avoiding carry-over confounding from previous disease activity.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Retinal layer thinning for monitoring disease-modifying treatment in relapsing multiple sclerosis-Evidence for applying a rebaselining concept.\",\"authors\":\"Gabriel Bsteh, Harald Hegen, Nik Krajnc, Fabian Föttinger, Patrick Altmann, Michael Auer, Klaus Berek, Barbara Kornek, Fritz Leutmezer, Stefan Macher, Tobias Monschein, Markus Ponleitner, Paulus Rommer, Christiane Schmied, Karin Zebenholzer, Gudrun Zulehner, Tobias Zrzavy, Florian Deisenhammer, Franziska Di Pauli, Berthold Pemp, Thomas Berger\",\"doi\":\"10.1177/13524585241267257\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Employing a rebaselining concept may reduce noise in retinal layer thinning measured by optical coherence tomography (OCT).</p><p><strong>Methods: </strong>From an ongoing prospective observational study, we included patients with relapsing multiple sclerosis (RMS), who had OCT scans at disease-modifying treatment (DMT) start (baseline), 6-12 months after baseline (rebaseline), and ⩾12 months after rebaseline. Mean annualized percent loss (aL) rates (%/year) were calculated both from baseline and rebaseline for peripapillary-retinal-nerve-fiber-layer (aLpRNFL<sub>baseline</sub>/aLpRNFL<sub>rebaseline</sub>) and macular-ganglion-cell-plus-inner-plexiform-layer (aLGCIPL<sub>baseline</sub>/aLGCIPL<sub>rebaseline</sub>) by mixed-effects linear regression models.</p><p><strong>Results: </strong>We included 173 RMS patients (mean age 31.7 years (SD 8.8), 72.8% female, median disease duration 15 months (12-94) median baseline-to-last-follow-up-interval 37 months (18-71); 56.6% moderately effective DMT (M-DMT), 43.4% highly effective DMT (HE-DMT)). Both mean aLpRNFL<sub>baseline</sub> and aLGCIPL<sub>baseline</sub> significantly increased in association with relapse (0.51% and 0.26% per relapse, <i>p</i> < 0.001, respectively) and disability worsening (1.10% and 0.48%, <i>p</i> < 0.001, respectively) before baseline, but not with DMT class. 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Retinal layer thinning for monitoring disease-modifying treatment in relapsing multiple sclerosis-Evidence for applying a rebaselining concept.
Background: Employing a rebaselining concept may reduce noise in retinal layer thinning measured by optical coherence tomography (OCT).
Methods: From an ongoing prospective observational study, we included patients with relapsing multiple sclerosis (RMS), who had OCT scans at disease-modifying treatment (DMT) start (baseline), 6-12 months after baseline (rebaseline), and ⩾12 months after rebaseline. Mean annualized percent loss (aL) rates (%/year) were calculated both from baseline and rebaseline for peripapillary-retinal-nerve-fiber-layer (aLpRNFLbaseline/aLpRNFLrebaseline) and macular-ganglion-cell-plus-inner-plexiform-layer (aLGCIPLbaseline/aLGCIPLrebaseline) by mixed-effects linear regression models.
Results: We included 173 RMS patients (mean age 31.7 years (SD 8.8), 72.8% female, median disease duration 15 months (12-94) median baseline-to-last-follow-up-interval 37 months (18-71); 56.6% moderately effective DMT (M-DMT), 43.4% highly effective DMT (HE-DMT)). Both mean aLpRNFLbaseline and aLGCIPLbaseline significantly increased in association with relapse (0.51% and 0.26% per relapse, p < 0.001, respectively) and disability worsening (1.10% and 0.48%, p < 0.001, respectively) before baseline, but not with DMT class. Contrarily, neither aLpRNFLrebaseline nor aLGCIPLrebaseline was dependent on relapse or disability worsening before baseline, while HE-DMT significantly lowered aLpRNFLrebaseline (by 0.31%, p < 0.001) and aLGCIPLrebaseline (0.25%, p < 0.001) compared with M-DMT.
Conclusions: Applying a rebaselining concept significantly improves differentiation of DMT effects on retinal layer thinning by avoiding carry-over confounding from previous disease activity.
期刊介绍:
Multiple Sclerosis Journal is a peer-reviewed international journal that focuses on all aspects of multiple sclerosis, neuromyelitis optica and other related autoimmune diseases of the central nervous system.
The journal for your research in the following areas:
* __Biologic basis:__ pathology, myelin biology, pathophysiology of the blood/brain barrier, axo-glial pathobiology, remyelination, virology and microbiome, immunology, proteomics
* __Epidemology and genetics:__ genetics epigenetics, epidemiology
* __Clinical and Neuroimaging:__ clinical neurology, biomarkers, neuroimaging and clinical outcome measures
* __Therapeutics and rehabilitation:__ therapeutics, rehabilitation, psychology, neuroplasticity, neuroprotection, and systematic management
Print ISSN: 1352-4585