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Effect of Teriflunomide and Dimethyl Fumarate on Cortical Atrophy and Leptomeningeal Inflammation in Multiple Sclerosis: A Retrospective, Observational, Case-Control Pilot Study

Background: Pathologic changes in cortical gray matter (GM) and leptomeninges contribute to disability worsening in patients with multiple sclerosis (MS), but there is little evidence whether disease-modifying treatments can slow down cortical pathology in MS. Objectives: To investigate the effect o...

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Autores principales: Zivadinov, Robert, Bergsland, Niels, Carl, Ellen, Ramasamy, Deepa P., Hagemeier, Jesper, Dwyer, Michael G., Lizarraga, Alexis A., Kolb, Channa, Hojnacki, David, Weinstock-Guttman, Bianca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463015/
https://www.ncbi.nlm.nih.gov/pubmed/30870983
http://dx.doi.org/10.3390/jcm8030344
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author Zivadinov, Robert
Bergsland, Niels
Carl, Ellen
Ramasamy, Deepa P.
Hagemeier, Jesper
Dwyer, Michael G.
Lizarraga, Alexis A.
Kolb, Channa
Hojnacki, David
Weinstock-Guttman, Bianca
author_facet Zivadinov, Robert
Bergsland, Niels
Carl, Ellen
Ramasamy, Deepa P.
Hagemeier, Jesper
Dwyer, Michael G.
Lizarraga, Alexis A.
Kolb, Channa
Hojnacki, David
Weinstock-Guttman, Bianca
author_sort Zivadinov, Robert
collection PubMed
description Background: Pathologic changes in cortical gray matter (GM) and leptomeninges contribute to disability worsening in patients with multiple sclerosis (MS), but there is little evidence whether disease-modifying treatments can slow down cortical pathology in MS. Objectives: To investigate the effect of teriflunomide (TFM) and dimethyl fumarate (DMF) in reducing cortical pathology, as determined by percentage cortical volume change (PCVC) and leptomeningeal contrast enhancement (LMCE) on MRI. Methods: This was a retrospective, single-center, observational study that selected 60 TFM- and 60 DMF-treated MS patients over 24 months. Results: TFM had a lower rate of PCVC compared to DMF over 24 months (−0.2% vs. −2.94%, p = 0.004). Similar results were observed for percentage GM volume change over 0–12 (p = 0.044) and 0–24 (−0.44% vs. −3.12%, p = 0.015) months. No significant differences were found between the TFM and DMF groups in the frequency and number of LMCE foci over the follow-up. TFM showed a numerically lower rate of whole brain atrophy over 24 months (p = 0.077), compared to DMF. No significant clinical or MRI lesion differences between TFM and DMF were detected over follow-up. Conclusions: These findings suggest that TFM has a superior effect on the preservation of cortical GM volume, compared to DMF.
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spelling pubmed-64630152019-04-19 Effect of Teriflunomide and Dimethyl Fumarate on Cortical Atrophy and Leptomeningeal Inflammation in Multiple Sclerosis: A Retrospective, Observational, Case-Control Pilot Study Zivadinov, Robert Bergsland, Niels Carl, Ellen Ramasamy, Deepa P. Hagemeier, Jesper Dwyer, Michael G. Lizarraga, Alexis A. Kolb, Channa Hojnacki, David Weinstock-Guttman, Bianca J Clin Med Article Background: Pathologic changes in cortical gray matter (GM) and leptomeninges contribute to disability worsening in patients with multiple sclerosis (MS), but there is little evidence whether disease-modifying treatments can slow down cortical pathology in MS. Objectives: To investigate the effect of teriflunomide (TFM) and dimethyl fumarate (DMF) in reducing cortical pathology, as determined by percentage cortical volume change (PCVC) and leptomeningeal contrast enhancement (LMCE) on MRI. Methods: This was a retrospective, single-center, observational study that selected 60 TFM- and 60 DMF-treated MS patients over 24 months. Results: TFM had a lower rate of PCVC compared to DMF over 24 months (−0.2% vs. −2.94%, p = 0.004). Similar results were observed for percentage GM volume change over 0–12 (p = 0.044) and 0–24 (−0.44% vs. −3.12%, p = 0.015) months. No significant differences were found between the TFM and DMF groups in the frequency and number of LMCE foci over the follow-up. TFM showed a numerically lower rate of whole brain atrophy over 24 months (p = 0.077), compared to DMF. No significant clinical or MRI lesion differences between TFM and DMF were detected over follow-up. Conclusions: These findings suggest that TFM has a superior effect on the preservation of cortical GM volume, compared to DMF. MDPI 2019-03-12 /pmc/articles/PMC6463015/ /pubmed/30870983 http://dx.doi.org/10.3390/jcm8030344 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zivadinov, Robert
Bergsland, Niels
Carl, Ellen
Ramasamy, Deepa P.
Hagemeier, Jesper
Dwyer, Michael G.
Lizarraga, Alexis A.
Kolb, Channa
Hojnacki, David
Weinstock-Guttman, Bianca
Effect of Teriflunomide and Dimethyl Fumarate on Cortical Atrophy and Leptomeningeal Inflammation in Multiple Sclerosis: A Retrospective, Observational, Case-Control Pilot Study
title Effect of Teriflunomide and Dimethyl Fumarate on Cortical Atrophy and Leptomeningeal Inflammation in Multiple Sclerosis: A Retrospective, Observational, Case-Control Pilot Study
title_full Effect of Teriflunomide and Dimethyl Fumarate on Cortical Atrophy and Leptomeningeal Inflammation in Multiple Sclerosis: A Retrospective, Observational, Case-Control Pilot Study
title_fullStr Effect of Teriflunomide and Dimethyl Fumarate on Cortical Atrophy and Leptomeningeal Inflammation in Multiple Sclerosis: A Retrospective, Observational, Case-Control Pilot Study
title_full_unstemmed Effect of Teriflunomide and Dimethyl Fumarate on Cortical Atrophy and Leptomeningeal Inflammation in Multiple Sclerosis: A Retrospective, Observational, Case-Control Pilot Study
title_short Effect of Teriflunomide and Dimethyl Fumarate on Cortical Atrophy and Leptomeningeal Inflammation in Multiple Sclerosis: A Retrospective, Observational, Case-Control Pilot Study
title_sort effect of teriflunomide and dimethyl fumarate on cortical atrophy and leptomeningeal inflammation in multiple sclerosis: a retrospective, observational, case-control pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463015/
https://www.ncbi.nlm.nih.gov/pubmed/30870983
http://dx.doi.org/10.3390/jcm8030344
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