%0 Journal Article
%T Retinal layer thinning for monitoring disease-modifying treatment in relapsing multiple sclerosis-Evidence for applying a rebaselining concept.
%A Bsteh G
%A Hegen H
%A Krajnc N
%A Föttinger F
%A Altmann P
%A Auer M
%A Berek K
%A Kornek B
%A Leutmezer F
%A Macher S
%A Monschein T
%A Ponleitner M
%A Rommer P
%A Schmied C
%A Zebenholzer K
%A Zulehner G
%A Zrzavy T
%A Deisenhammer F
%A Di Pauli F
%A Pemp B
%A Berger T
%J Mult Scler
%V 30
%N 9
%D 2024 Aug 7
%M 39109593
%F 5.855
%R 10.1177/13524585241267257
%X UNASSIGNED: Employing a rebaselining concept may reduce noise in retinal layer thinning measured by optical coherence tomography (OCT).
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.