Modified Rio Score with Platform Therapy Predicts Treatment Success with Fingolimod and Natalizumab in Relapsing-Remitting Multiple Sclerosis Patients.
BACKGROUND
Reliable markers of disease outcomes in multiple sclerosis (MS) would help to predict the response to treatment in patients treated with high efficacy drugs. No evidence of disease activity (NEDA) has become a treatment goal whereas the modified Rio score (MRS) predicts future suboptimal responders to treatment. The aim of our study was to identify factors that would predict poor response to treatment with natalizumab and fingolimod.


METHODS
In the multicenter prospective trial, 336 subjects were enrolled, initiating therapy with natalizumab (n = 135) or fingolimod (n = 201). Data on relapse rate, the expanded disability status scale, and MRI results were collected, and MRS was estimated.


RESULTS
NEDA-3 after the first year of therapy was 73.9% for natalizumab and 54.8% for fingolimod (p < 0.0001). Patients with MRS = 0 in the last year on platform therapy had the best NEDA-3 (71%) and patients with MRS = 3 had the worst NEDA-3 (41%) in the first year of treatment with the second-line therapy.


CONCLUSION
We conclude that switching to the second-line therapy should occur earlier to enable better results for patients treated with natalizumab or fingolimod. The outcome on both drugs is better with better neurological conditions and lower MRS of the patient on the platform therapy.
['Jamroz-Wiśniewska|Anna|A|0000-0002-2905-3777', 'Zajdel|Radosław|R|0000-0002-1654-8957', 'Słowik|Agnieszka|A|0000-0002-8261-537X', 'Marona|Monika|M|', 'Wnuk|Marcin|M|0000-0002-1090-7496', 'Adamczyk-Sowa|Monika|M|', 'Adamczyk|Bożena|B|', 'Lasek-Bal|Anetta|A|', 'Puz|Przemysław|P|', 'Stęposz|Arkadiusz|A|', 'Krzystanek|Ewa|E|', 'Patalong-Ogiewa|Maja|M|', 'Pokryszko-Dragan|Anna|A|', 'Budrewicz|Sławomir|S|', 'Koziarska|Dorota|D|0000-0003-1548-184X', 'Karbicka|Anna|A|', 'Wawrzyniak|Sławomir|S|', 'Fryze|Waldemar|W|', 'Furtak-Niczyporuk|Marzena|M|', 'Rejdak|Konrad|K|0000-0002-7019-6681']
fingolimod natalizumab no evidence of disease activity (NEDA) modified Rio score (MRS) relapsing-remitting type of multiple sclerosis