TY - JOUR
AU1 - Miller, David H.
AU2 - Lublin, Fred D.
AU3 - Sormani, Maria Pia
AU4 - Kappos, Ludwig
AU5 - Yaldizli, Özgür
AU6 - Freedman, Mark S.
AU7 - Cree, Bruce A. C.
AU8 - Weiner, Howard L.
AU9 - Lubetzki, Catherine
AU1 - Hartung, Hans‐Peter
AU1 - Montalban, Xavier
AU1 - Uitdehaag, Bernard M. J.
AU1 - MacManus, David G.
AU1 - Yousry, Tarek A.
AU1 - Gandini Wheeler‐Kingshott, Claudia A. M.
AU1 - Li, Bingbing
AU1 - Putzki, Norman
AU1 - Merschhemke, Martin
AU1 - Häring, Dieter A.
AU2 - Wolinsky, Jerry S.
AB - IntroductionThe INFORMS study evaluated the effect of fingolimod 0.5 mg versus placebo on disability progression in patients with primary progressive multiple sclerosis (PPMS) treated for at least 3 years. Patients recruited to the INFORMS study had low inflammatory MRI activity at baseline and on study, a low on‐study relapse rate, and a high on‐study progression rate. Despite the low level of inflammatory activity, approximately 80% of the INFORMS population experienced a 3‐month confirmed disability progression. Although fingolimod significantly reduced inflammatory activity relative to placebo, the composite primary efficacy endpoint of disability progression was not met, indicating that fingolimod's anti‐inflammatory effects did not slow disease worsening in PPMS. This observation suggests that concurrent inflammatory disease activity as measured by new lesion formation on brain MRI is not the primary mechanism of disability progression in PPMS.Many studies in relapse‐onset multiple sclerosis (RMS) found a relationship between brain volume loss and disability worsening. Moreover, patients with RMS and a small normalized brain volume are significantly more likely to worsen over 4 years than patients with large normalized brain volume but otherwise similar baseline characteristics. Fingolimod reduced the risk of disability worsening in relapsing‐remitting MS (RRMS) and consistently reduced brain volume loss by more than 30% 
TI - Brain atrophy and disability worsening in primary progressive multiple sclerosis: insights from the INFORMS study
JF - Annals of Clinical and Translational Neurology
DO - 10.1002/acn3.534
DA - 2018-01-01
UR - https://www.deepdyve.com/lp/wiley/brain-atrophy-and-disability-worsening-in-primary-progressive-multiple-7WOGT02jWF
SP - 346
EP - 356
VL - 5
IS - 3
DP - DeepDyve
ER -