Does First Year MRI and Clinical Activity Correlate with Long Term Clinical Response to Glatiramer Acetate in Multiple Sclerosis Patients? (P01.194)

OBJECTIVE: To assess whether clinical/MRI parameters at baseline/12 months of continuous glatiramer acetate(GA)therapy can predict long term disability in patients with relapsing MS initiated on GA as their first disease modifying therapy(DMT). BACKGROUND: Identifying “real word” early predictors for response to DMT9s is desirable. New T2 hyperintense(T2H)brain MRI lesions during first year of Interferon treatment were associated with increased risk for disability progression after 3-5 years of therapy. GA9s unique mechanism of action compared to interferon raise the consideration that MRI metrics after one year of GA therapy may have different significance. DESIGN/METHODS: Retrospective chart review identified 148 eligible MS patients being on GA (>1 year) as their initial DMT. Patients with any previous significant exposure (>12 months) to immunosuppressants were excluded .Data included demographics, EDSS at baseline(0) and follow up while on GA, number and dates of relapses during the year preceding the start of GA and relapses during first year of GA therapy, time and reason for cessation of GA. Radiological data included baseline/follow-up yearly MRI9s. RESULTS: 133 female and 15 male patients [mean age 42.8 (0.9) years] had baseline EDSS(0) of 2.49 (1.6) and EDSS(1) (at 320±20 days) 2.48 (1.5). At baseline, 26.4% of patients had enhancing lesions (T1Gd+). Brain MRI(1) showed new T2H lesions in 26.4% and 13.1% T1Gd(+), while brain MRI(2) showed new T2H lesions in 21.8%, and 10% had T1Gd(+). Brain MRI(3) showed T2H in 10% and 3.7% T1Gd(+).EDSS over 5 years (N=144, 135, 112, 48 at 1, 2, 3, 5 years respectively) were noted to be stable for all patients [2.5(0) -2.7(5)]. CONCLUSIONS: Patients on GA after one to two years harbor new brain MRI T1Gd(+) and T2H lesions, which decline over the third year. The significance of new and enhancing MRI lesions and their predictive value over 5 years of follow up will be presented. Supported by: Teva. Disclosure: Dr. Karmon has nothing to disclose. Dr. Ramanathan has received personal compensation for activities with Serono Inc., Biogen Idec, Allergan, Inc., Netezza, Pfizer, Novartis, the National Multiple Sclerosis Society, the Department of Defense, Jog for the Jake Foundation and the National Institutes of Health as a consultant. Dr. Ramanathanhas received personal compensation in an editorial capacity for American Association of Pharmaceutical Scientists. Dr. Ramanathan has received research support from Serono Inc., Biogen Idec, Allergan Inc., Netezza, Pfizer, Novartis, the National Multiple Sclerosis Society, the Department of Defense, Jog for the Jake Foundation, the National Institutes of Health. Dr. Weinstock-Guttman has received personal compensation for activities with Acorda Therapeutics, Biogen Idec, Serono Inc., Novartis, Pfizer, Inc., Teva Neuroscience and Genentech, Inc. as a speaker and/or participant on an advisory board. Dr. Weinstock-Guttman has received research support from the National Multiple Sclerosis Society, the National Institutes of Health, ITN, Teva Neuroscience, Biogen Idec, Serono Inc., Aspreva-Roche, Acorda Therapeutics & Cognition, Shire Pharmaceuticals Group and Novartis.