1596 [940] << Receiving treatment more frequently was associated with a relative risk reduction of time to conversion to CDMS compared to receiving treatment less frequently after 60 months. 
pp.
1241 [940] xVn0+.PP-P z(zjAS KJ6Lg4mz"9y(_G"?/_%8 @.O1v#sg3l #:m?gK#q^7@gnP)h*i}g4JlG+Br> rGp1tF10Y !&H>MH ' 65;t`;o-kb]X}lhX 7,[z~c+6_b,>Kc;Yb]CG~$+u*8IGNP vbo/{x`h=o?/:(>\96uuNE/9qO0NDPa$XLL_Lo{TD3PCG.O>HuynZ^YN]I1R4jz%EoL\]E)J!k3|f4mk1s.Y]S7\2;,-3lHs|>^>/C_CsV*:v=mGB^bd0c261VgxNO_
1433 [940] /Subtype /CIDFontType2 /ToUnicode 10 0 R 
1594 [940] 1577 [940] 10 0 obj ARVO (1962-2015); The Authors (2016-present). Sujani Madhurika Kodagoda Gamage, Indunil Wijeweera, Priyangi Wijesinghe, Sanjaya Bandara Adikari, Katharina Fink and Herath Mudiyanselage Ajith Sominanda. Results :
/Resources 6 0 R 1808 [940] :
9 0 obj >> 13 [303] WoS KCI . This PDF is available to Subscribers Only, A Meta-Analysis Study of the Effect of Early Intervention on Disease Progression in Patients with Clinically Isolated Syndrome to Multiple Sclerosis, College of Health Sciences, Tusculum University, Greeneville, Tennessee, United States, You will receive an email whenever this article is corrected, updated, or cited in the literature. 1908 [940] define several concepts. 19 [606] 
Baseline and follow-up MRI scans were performed within 3 months from the initial presentation and at one year after baseline MRI, respectively. 9 [363 363] endobj
stream Purpose : Hybrid Clinical Trials, Subcutaneous interferon -1a in the treatment of clinically isolated syndromes: 3-year and 5-year results of the phase III dosing frequency-blind multicentre REFLEXION study, Journal of Neurology, Neurosurgery, and Psychiatry, What I Didnt Do on My Forced Summer Holiday Due to the UK Heat Wave, Dreams, Diagnoses, and Disclosures: When to Tell Others About MS, No Link Between MS Severity, Vitamin D-related Mutations: Study, Early Rebif Treatment Prolongs Progression to Clinically Definite MS, Study Reports. 5 0 obj CPMS Clinically probable MS, with less restrict combinations. This site is strictly a news and information website about the disease. Patients were followed-up for 2 years to assess the conversion to clinically definite multiple sclerosis (CDMS). 8 0 obj 2633 [940] [5] Poser criteria were published in 1983 and their sensitivity increased with time. << 15 [303] 1502 [940]
2226 [940]
2202 [940] 1205 [940] Applicability of McDonald 2010 and Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) 2016 Magnetic Resonance Imaging Criteria for the Diagnosis of Multiple Sclerosis in Sri Lanka. 42 [242] The Risk ratios (RRs), Od rations (ODs), 95 % CI and p values were calculated in each study protocol to express the comparison of the treated group to the placebo group. <> /Type /Page Available from: doi:https://doi.org/10.3988/jcn.2018.14.3.339. Publication bias was evaluated. The aim of the present study was to systematically evaluate the effect of drugs on the progression of CIS to MS. endobj 16 0 obj @article{ART002361472,author={Sujani Madhurika Kodagoda Gamage and Indunil Wijeweera and Priyangi Wijesinghe and Sanjaya Bandara Adikari and Katharina Fink and Herath Mudiyanselage Ajith Sominanda},title={Applicability of McDonald 2010 and Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) 2016 Magnetic Resonance Imaging Criteria for the Diagnosis of Multiple Sclerosis in Sri Lanka},journal={Journal of Clinical Neurology},issn={1738-6586},year={2018},volume={14},number={3},pages={339-344},doi={https://doi.org/10.3988/jcn.2018.14.3.339},url={https://doi.org/10.3988/jcn.2018.14.3.339} }, TY - JOURAU - Sujani Madhurika Kodagoda GamageAU - Indunil WijeweeraAU - Priyangi WijesingheAU - Sanjaya Bandara AdikariAU - Katharina FinkAU - Herath Mudiyanselage Ajith SominandaTI - Applicability of McDonald 2010 and Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) 2016 Magnetic Resonance Imaging Criteria for the Diagnosis of Multiple Sclerosis in Sri LankaT2 - Journal of Clinical NeurologyJO - Journal of Clinical NeurologyPY - 2018VL - 14IS - 3PB - SP - 339EP - 344SN - 1738-6586AB - Background and Purpose The magnetic resonance imaging in multiple sclerosis (MAGNIMS) group recently proposed guidelines to replace the existing dissemination-in-space criteria in McDonald 2010 magnetic resonance imaging (MRI) criteria for diagnosing multiple sclerosis. >> MAGNIMS 2016 MRI criteria were fulfilled by 29, with 28 converting to CDMS. Therefore, the concept of "clinical MS", for a MS that can be diagnosed is sometimes too strong because until MS diagnosis has been established, nobody can tell whether the disease dealing with is MS.[citation needed], Cases of MS before the CIS are sometimes found during other neurological inspections and are referred to as "subclinical MS". . /W [0 [940 280] This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019. <> 3303 [940] We consulted some of our community contributors at MS News Today and came up with 12 questions people should consider asking their doctors after an MS diagnosis. 39 [503]
>> 1925 [940] stream 2443 [940] ?:0FBx$ !i@H[EE1PLV6QP>U(j 68 [484 606 545 363 606] Vis. When using the McDonald criteria, dose frequency of Rebifaffected time to progression.
Conclusions MAGNIMS 2016 MRI criteria were superior to McDonald 2010 MRI criteria in specificity, accuracy, and PPV, but inferior in sensitivity and NPV.KW - multiple sclerosis, McDonald 2010 magnetic resonance imaging criteria, magnetic resonance imaging in multiple sclerosis 2016 magnetic resonance imaging criteria, McDonald 2017 magnetic resonance imaging criteria, performance, AsiaDO - https://doi.org/10.3988/jcn.2018.14.3.339UR - https://doi.org/10.3988/jcn.2018.14.3.339ER -. endobj 15 0 obj Alternatively, the McDonald approach uses magnetic resonance imaging (MRI), which takes into account the presence and extent of identified lesions to diagnose and monitor CDMS. In all groups the number of patients who converted to CDMS had increased at month 60. << Traditional vs. Therefore, Poser criteria should be considered as deprecated. (2018). /BaseFont /AAENRK+NanumGothic no.3, It does not provide medical advice, diagnosis or treatment. 1521 [940] endobj Email: [emailprotected] @Rt CXCP%CBH@Rf[(t CQhz#0 Zl`O828.p|OX %PDF-1.4 2496 [940] endobj 2640 [940 940] Conclusions MAGNIMS 2016 MRI criteria were superior to McDonald 2010 MRI criteria in specificity, accuracy, and PPV, but inferior in sensitivity and NPV. 1 0 obj << /FontDescriptor 12 0 R The Ependymal "Dot-Dash" Sign: An MR Imaging Finding of Early Multiple Sclerosis, AJNR Am J Neuroradiol 26:20332036, September 2005, "New diagnostic criteria for multiple sclerosis: Guidelines for research protocols", Lesional demyelinations of the central nervous system, Experimental autoimmune encephalomyelitis, Leukoencephalopathy with vanishing white matter, Megalencephalic leukoencephalopathy with subcortical cysts, Transfusion-associated graft versus host disease, https://en.wikipedia.org/w/index.php?title=Poser_criteria&oldid=1050248552, Articles with unsourced statements from October 2021, Articles with unsourced statements from January 2019, Creative Commons Attribution-ShareAlike License 3.0, Two attacks and one evidence (clinical or paraclinical), Attack: Occurrence of a symptom of neurological dysfunction for more than 24 hours, Clinical evidence: Neurological dysfunction demonstrable by neurological examination, Paraclinical evidence: Demonstration by any test of the existence of a non-clinical lesion in the CNS, CDMS Clinically definite MS. / () endobj Available from: doi:https://doi.org/10.3988/jcn.2018.14.3.339, Sujani Madhurika Kodagoda Gamage, Indunil Wijeweera, Priyangi Wijesinghe, Sanjaya Bandara Adikari, Katharina Fink and Herath Mudiyanselage Ajith Sominanda. 1994 [940] /Encoding /Identity-H MAGNIMS 2016 MRI criteria were fulfilled by 29, with 28 converting to CDMS. Sujani Madhurika Kodagoda Gamage, Indunil Wijeweera, Priyangi Wijesinghe, Sanjaya Bandara Adikari, Katharina Fink, Herath Mudiyanselage Ajith Sominanda "Applicability of McDonald 2010 and Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) 2016 Magnetic Resonance Imaging Criteria for the Diagnosis of Multiple Sclerosis in Sri Lanka" Journal of Clinical Neurology 14.3 pp.339-344 (2018) : 339. 36 [672 727] Thirty-seven fulfilled the McDonald 2010 MRI criteria, and 33 converted to CDMS. Thirty-seven fulfilled the McDonald 2010 MRI criteria, and 33 converted to CDMS. Observational studies, case series, case reports, RCTs without placebo subgroups, and studies reporting the use of drugs that has not being completed or terminated or still under recruitment or are not still officially approved were excluded. <> /Filter /FlateDecode Phone: 1-800-936-1363. Contact us for more information. 1 0 obj There has been insufficient research regarding their applicability in Asians. 19 0 obj 2596 [940] Sci. 3354 [940 940 940 940] 10 0 obj This further supports the early initiation of treatment with [Rebif] at the time of the FCDE, with patients receiving [early treatment] benefiting from improved outcomes.. The REFLEXION study evaluated the benefits of more frequent and early dosing vs. delayed treatment on the course of the disease over 60 months. 2687 [940] 2660 [940] 2604 [940]
Patients were followed-up for 2 years to assess the conversion to clinically definite multiple sclerosis (CDMS). >> Drug treated group were found to have significantly lower risk of progression compared to placebo ( RR= 0.675, 95 % CI:0.605-0.753; P<0.001, and an Odd Ratio (OR), OR =0.373, 95 % 0.251-0.554; P < 0.001) were calculated. 49 [577] 1451 [940]
<> URL . /Type /Font The systematic review included an electronic search of EMBASE, MEDLINE, PUBMED, Clinicaltrials.gov and Cochrane databases to include all available placebo-controlled randomized clinical trials (RCT) of early intervention of CIS progression to clinically defined MS (CDMS) or Defined MS (DMS), comparing the treated group patients versus non treated group (Placebo) that reported absolute numbers or percentages of progression during each study, from January 1, 2007 through November 1, 2018. Results Forty-two of 66 patients converted to CDMS. The aim of the present study was to systematically evaluate the effect of drugs on the progression of CIS to MS. Methods : @~ (* {d+}G}WL$cGD2QZ4 E@@ A(q`1D `'u46ptc48.`R0) 2680 [940] J Clin Neurol, 2018, vol.14, /Parent 2 0 R endobj Objective of this study was to determine the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of McDonald 2010 and MAGNIMS 2016 MRI criteria with the aim of verifying their applicability in Sri Lankan patients.
/CIDToGIDMap 13 0 R <>
>> Stacy Grieve, PhD The Risk ratios (RRs), Od rations (ODs), 95 % CI and p values were calculated in each study protocol to express the comparison of the treated group to the placebo group. In total, 402 patients continued in the REFLEXION trial. McDonald 2010 and MAGNIMS 2016 MRI criteria were applied to all MRI scans. Sign in or purchase a subscription to access this content. endstream 1842 [940 940] >> 2966 [940] 3 W Garden St /Contents 5 0 R Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, Translational Vision Science & Technology. *1 J "6DTpDQ2(C"QDqpIdy~kg} LX Xg` l pBF|l *? Y"1 P\8=W%O4M0J"Y2Vs,[|e92se'9`2&ctI@o|N6 (.sSdl-c(2-y H_/XZ.$&\SM07#1Yr fYym";8980m-m(]v^DW~ emi ]P`/ u}q|^R,g+\Kk)/C_|Rax8t1C^7nfzDpu$/EDL L[B@X! Results from REFLEX showed that early treatment with Rebif 44micrograms, initiated after FCDE and administered subcutaneously (beneath the skin) three times a week or once weekly over 24months delayed conversion to CDMS compared with placebo. 9 0 obj endobj /MediaBox [0.0 0.0 595.275 841.875] endobj /Length 777 3294 [940] The systematic review included an electronic search of EMBASE, MEDLINE, PUBMED, Clinicaltrials.gov and Cochrane databases to include all available placebo-controlled randomized clinical trials (RCT) of early intervention of CIS progression to clinically defined MS (CDMS) or Defined MS (DMS), comparing the treated group patients versus non treated group (Placebo) that reported absolute numbers or percentages of progression during each study, from January 1, 2007 through November 1, 2018. Publication bias was evaluated. 1586 [940] For example, in 1988 a 94% specificity vs. postmortem analysis was reported [6]Anyway, in initial cases, the sensitivity was low respect pathologically defined MS because around 25% of MS cases are silent MS cases. 20 0 obj <> <> The treatment group was found to have lower risk of progression to develop to CDMS or DMS than the untreated group, and due to the fact that individuals who were treated early tend to have better outcome, we suggest that intervention early treatment should be routinely considered. Poser diagnosis of CDMS is known to have a sensitivity of 87% respect postmortem autopsy examination[4], Poser et al. 2489 [940] There was no observed difference between the different dose frequencies (three times weekly vs. once a week). [7], Two pathologically disseminated inflammatory demyelinating lesions should be considered MS even if they are silent. An extension of a Phase 3 clinical trial has shown that early treatment with Rebif (interferon beta-1a) in patients with initial manifestations of multiple sclerosis (MS) can prolong the time to a clinically definite multiple sclerosis (CDMS) diagnosis over fiveyears. 2768 [940 940] These audio news stories give our readers an alternative option for accessing information important for them. 2773 [940] <> However, patients receiving early treatment were still less likely to progress than patients with a delayed treatment. 1789 [940] 1856 [940] <> 339-344. Patients who originally received a placebo who had not converted to CDMS were switched to Rebif three times a week and formed the delayed treatment group. /Version /1.7 CDMS can be diagnosed based on a new attack or a sustained increase in disability. 2342 [940] The most important for diagnosis are:[citation needed], The criteria can yield five conclusions:[citation needed]. 83 [363 424 363 606 484] Mashael Namaeh, Andrew Buzzelli; A Meta-Analysis Study of the Effect of Early Intervention on Disease Progression in Patients with Clinically Isolated Syndrome to Multiple Sclerosis. 13 0 obj << The sensitivity, specificity, accuracy, PPV, and NPV were 78%, 83%, 64%, 89%, and 69%, respectively, for the McDonald 2010 criteria, and 67%, 96%, 77%, 96%, and 62% for the MAGNIMS 2016 MRI criteria. endobj 1518 [940] Remote vs. Moreover, no evidence of publication bias was detected in the funnel plot inspection or in the Eggers statistical test (p=0.45). 2018; 14(3), 339-344. endobj REFLEXION was an extension study of the multi-center double-blind REFLEX (NCT00404352) Phase 3study. Sujani Madhurika Kodagoda Gamage, Indunil Wijeweera, Priyangi Wijesinghe, Sanjaya Bandara Adikari, Katharina Fink, Herath Mudiyanselage Ajith Sominanda. This page was last edited on 16 October 2021, at 17:55. 2647 [940] Several early intervention drugs are being tested in clinical trials for the early intervention in patients with clinically isolated syndrome (CIS) which may leads to Multiple Sclerosis (MS). The Poser diagnosis criteria for MS does not allow doctors normally to give an MS diagnosis until a second attack takes place. 11 0 obj Sujani Madhurika Kodagoda Gamage, Indunil Wijeweera, Priyangi Wijesinghe, Sanjaya Bandara Adikari, Katharina Fink and Herath Mudiyanselage Ajith Sominanda. No evidence of statistical heterogeneity was found ( I. Based on this, the authors defined a set of rules that can yield five conclusions:[3] CDMS, LSDMS, CPMS, LSPMS or noMS. endobj 2571 [940] stream 1175 [940] endobj The study, Subcutaneous interferon -1a in the treatment of clinically isolated syndromes: 3-year and 5-year results of the phase III dosing frequency-blind multicentre REFLEXION study, reports the findings of the REFLEXION clinical trial (NCT00813709) conducted in 24 countries. 3 0 obj Database search yielded to only 6 potential related eligible RCTs that met the inclusion criteria of a total of 1569 participants for the meta-analysis study. "Applicability of McDonald 2010 and Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) 2016 Magnetic Resonance Imaging Criteria for the Diagnosis of Multiple Sclerosis in Sri Lanka" Journal of Clinical Neurology 14, no.3 (2018) : 339-344.doi: https://doi.org/10.3988/jcn.2018.14.3.339, Sujani Madhurika Kodagoda Gamage; Indunil Wijeweera; Priyangi Wijesinghe; Sanjaya Bandara Adikari; Katharina Fink; Herath Mudiyanselage Ajith Sominanda. 7 0 obj [8] "Preclinical MS" refers to cases after the CIS but before the confirming second attack. No MS There is no clinical evidence of having MS. Several early intervention drugs are being tested in clinical trials for the early intervention in patients with clinically isolated syndrome (CIS) which may leads to Multiple Sclerosis (MS). >> endobj /Count 1 /BaseFont /AAENRK+NanumGothic <> The sensitivity, specificity, accuracy, PPV, and NPV were 78%, 83%, 64%, 89%, and 69%, respectively, for the McDonald 2010 criteria, and 67%, 96%, 77%, 96%, and 62% for the MAGNIMS 2016 MRI criteria. 90 [464] endobj [9] After the second confirming attack the situation is referred to as CDMS (clinically defined multiple sclerosis). Applicability of McDonald 2010 and Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) 2016 Magnetic Resonance Imaging Criteria for the Diagnosis of Multiple Sclerosis in Sri Lanka. Baseline and follow-up MRI scans were performed within 3 months from the initial presentation and at one year after baseline MRI, respectively. endobj Invest. [citation needed], The first manifestation of MS is the so-called clinically isolated syndrome, or CIS, which is the first isolated attack. The sensitivity, specificity, accuracy, PPV, and NPV for predicting the conversion to CDMS were calculated. This data suggests that early intervention lead to 32.5 % reduction in the risk of conversion of CIS to CDMS or DMS and 37.3 % reduction in the odds of conversion of CIS to CDMS or DMS. endobj , McDonald 2010 magnetic resonance imaging criteria, magnetic resonance imaging in multiple sclerosis 2016 magnetic resonance imaging criteria, McDonald 2017 magnetic resonance imaging criteria. The authors suggest that monitoring MRI lesions according to the McDonald criteria provides a more sensitive tool to measure disease activity. 339-344 (6 pages), 3Sirimavo Bandaranayaka Specialized Childrens Hospital. 2515 [940] 2440 [940 940] Journal of Clinical Neurology, 14(3), 339-344. 2864 [940] /Length 702 x]8F X%b}tnNp/g6>R$+cz.||==21y|LYQ=exvK}|{^Cw>_y#=2_v>=gC~_e?ocSp~]o1/I)t=i=!!~;X~c. 3372 [940] << March 23, 2017. The results of REFLEXION extend the clinical and MRI findings of the REFLEX study and show that, over 5years in patients with an FCDE, early initiation of treatment with [Rebif] prolonged time to CDMS and McDonald MS, and reduced MRI activity compared with [delayed treatment], the team concluded. endobj >> << By continuing to use our website, you are agreeing to, Investigative Ophthalmology & Visual Science. | You can manage this and all other alerts in. Suite 700 After 36 months, patients with delayed treatment had a 41.3% cumulative probability of progressing to CDMS compared to approximately 27% for patients who received either dose of Rebif. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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/DescendantFonts [9 0 R] /Pages 2 0 R Methods Patients with clinically isolated syndrome diagnosed by consultant neurologists were recruited from five major neurology centers. 4 0 obj Any of the five conclusions have subpossibilities. %PDF-1.4 3377 [940] Copyright 2015 Association for Research in Vision and Ophthalmology. Studies have shown that 38% to 45% of untreated patients will progress to CDMS within two years. /Type /Catalog 2615 [940] <> This site uses cookies. Journal of Clinical Neurology, 14(3), 339-344. doi: https://doi.org/10.3988/jcn.2018.14.3.339, Sujani Madhurika Kodagoda Gamage; Indunil Wijeweera; Priyangi Wijesinghe; Sanjaya Bandara Adikari; Katharina Fink; Herath Mudiyanselage Ajith Sominanda. by 2019;60(9):2279. [10], Christopher J. Lisanti, Patrick Asbach, and William G. Bradley, Jr. /Subtype /Type0 2239 [940] 46 [969] [citation needed], As more knowledge about the underlying pathology of MS has been gathered, the concepts of subclinical, preclinical and CIS have been used together with the Poser original classification. Patients who received Rebif44micrograms three times or once weekly in the REFLEX trial and whohad not progressed to CDMS continued with their original treatment regimen. Website: bionews.com % /Font 7 0 R They replaced the older Schumacher criteria,[1] and now they are considered obsolete as McDonald criteria have superseded them. Here a table is shown with each one of them: If none of these requirements is accomplished, the diagnosis is "No MS", meaning that there is not enough clinical evidence to support a clinical diagnosis of MS. Poser diagnosis of CDMS was initially reported to have a sensitivity of 87% respect postmortem autopsy examination.