Effects of Fingolimod and Natalizumab on Brain T1-/T2-Weighted and Magnetization Transfer Ratios: a 2-Year Study.
Adult
Brain
/ diagnostic imaging
Female
Fingolimod Hydrochloride
/ pharmacology
Humans
Immunologic Factors
/ pharmacology
Immunosuppressive Agents
/ pharmacology
Longitudinal Studies
Magnetic Resonance Imaging
/ methods
Male
Middle Aged
Multiple Sclerosis, Relapsing-Remitting
/ diagnostic imaging
Natalizumab
/ pharmacology
Prospective Studies
Time Factors
MRI
Multiple sclerosis
T1w/T2w-ratio
disease-modifying drugs
magnetization transfer ratio
neuroprotection
repair
Journal
Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics
ISSN: 1878-7479
Titre abrégé: Neurotherapeutics
Pays: United States
ID NLM: 101290381
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
accepted:
18
12
2020
pubmed:
24
1
2021
medline:
29
1
2022
entrez:
23
1
2021
Statut:
ppublish
Résumé
Fingolimod and natalizumab significantly reduce disease activity in relapsing-remitting multiple sclerosis (RRMS) and could promote tissue repair and neuroprotection. The ratio between conventional T1- and T2-weighted sequences (T1w/T2w-ratio) and magnetization transfer ratio (MTR) allow to quantify brain microstructural tissue abnormalities. Here, we compared fingolimod and natalizumab effects on brain T1w/T2w-ratio and MTR in RRMS over 2 years of treatment. RRMS patients starting fingolimod (n = 25) or natalizumab (n = 30) underwent 3T brain MRI scans at baseline (T0), month 6 (M6), month 12 (M12), and month 24 (M24). White matter (WM) lesions, normal-appearing (NA) WM, and gray matter (GM) T1w/T2w-ratio and MTR were estimated and compared between groups using linear mixed models. No baseline demographic, clinical, and MRI difference was found between groups. In natalizumab patients, lesion T1w/T2w-ratio and MTR significantly increased at M6 vs. T0 (p ≤ 0.035) and decreased at subsequent timepoints (p ≤ 0.037). In fingolimod patients, lesion T1w/T2w-ratio increased at M12 vs. T0 (p = 0.010), while MTR gradually increased at subsequent timepoints vs. T0 (p ≤ 0.027). Natalizumab stabilized NAWM and GM T1w/T2w-ratio and MTR. In fingolimod patients, NAWM T1w/T2w-ratio and MTR significantly increased at M24 vs. M12 (p ≤ 0.001). A significant GM T1w/T2w-ratio decrease at M6 vs. T0 (p = 0.014) and increase at M24 vs. M6 (p = 0.008) occurred, whereas GM MTR was significantly higher at M24 vs. previous timepoints (p ≤ 0.017) with significant between-group differences (p ≤ 0.034). Natalizumab may promote an early recovery of lesional damage and prevent microstructural damage accumulation in NAWM and GM during the first 2 years of treatment. Fingolimod enhances tissue damage recovery being visible after 6 months in lesions and after 2 years in NAWM and GM.
Identifiants
pubmed: 33483938
doi: 10.1007/s13311-020-00997-1
pii: 10.1007/s13311-020-00997-1
pmc: PMC8423925
doi:
Substances chimiques
Immunologic Factors
0
Immunosuppressive Agents
0
Natalizumab
0
Fingolimod Hydrochloride
G926EC510T
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
878-888Informations de copyright
© 2021. The American Society for Experimental NeuroTherapeutics, Inc.
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pmcid: 7975997