UNASSIGNED: From an ongoing prospective observational study, we included patients with relapsing multiple sclerosis (RMS), who had OCT scans at disease-modifying treatment (DMT) start (baseline), 6-12 months after baseline (rebaseline), and ⩾12 months after rebaseline. Mean annualized percent loss (aL) rates (%/year) were calculated both from baseline and rebaseline for peripapillary-retinal-nerve-fiber-layer (aLpRNFLbaseline/aLpRNFLrebaseline) and macular-ganglion-cell-plus-inner-plexiform-layer (aLGCIPLbaseline/aLGCIPLrebaseline) by mixed-effects linear regression models.
UNASSIGNED: We included 173 RMS patients (mean age 31.7 years (SD 8.8), 72.8% female, median disease duration 15 months (12-94) median baseline-to-last-follow-up-interval 37 months (18-71); 56.6% moderately effective DMT (M-DMT), 43.4% highly effective DMT (HE-DMT)). Both mean aLpRNFLbaseline and aLGCIPLbaseline significantly increased in association with relapse (0.51% and 0.26% per relapse, p < 0.001, respectively) and disability worsening (1.10% and 0.48%, p < 0.001, respectively) before baseline, but not with DMT class. Contrarily, neither aLpRNFLrebaseline nor aLGCIPLrebaseline was dependent on relapse or disability worsening before baseline, while HE-DMT significantly lowered aLpRNFLrebaseline (by 0.31%, p < 0.001) and aLGCIPLrebaseline (0.25%, p < 0.001) compared with M-DMT.
UNASSIGNED: Applying a rebaselining concept significantly improves differentiation of DMT effects on retinal layer thinning by avoiding carry-over confounding from previous disease activity.
■根据一项正在进行的前瞻性观察研究,我们纳入了复发性多发性硬化症(RMS)患者,在疾病改善治疗(DMT)开始(基线)时进行了OCT扫描,基线后6-12个月(重新基线),以及重新基线后的12个月。通过混合效应线性模型回归计算,从基线和再基线计算乳头周围视网膜神经纤维层(aLpRNFLbaseline/aLpRNFLrebaseline)和黄斑神经节细胞加内丛状层(aLGCIPLbaseline/aLGCIPLrebaseline)的平均年损失率(%/年)。
■我们包括173名RMS患者(平均年龄31.7岁(SD8.8),72.8%女性,中位疾病持续时间15个月(12-94),中位基线至最后一次随访间隔37个月(18-71);56.6%中度有效DMT(M-DMT),43.4%高效DMT(HE-DMT))。平均aLpRNFLbaseline和aLGCIPLbaseline均与复发相关显着增加(每次复发0.51%和0.26%,p分别<0.001)和残疾恶化(1.10%和0.48%,p<0.001,分别)在基线前,但不是DMT类。相反,aLpRNFLrebaseline和aLGCIPLrebaseline均不依赖于基线前的复发或残疾恶化,而HE-DMT显着降低了aLpRNFLrebaseline(下降了0.31%,p<0.001)和aLGCIPLrebaseline(0.25%,p<0.001)与M-DMT相比。
■应用重新基线化概念通过避免先前疾病活动的遗留混淆,显着提高了DMT对视网膜层变薄的影响的区分。