MS Briefs

Key clinical point: Switching to personalized extended interval dosing of natalizumab did not result in recurrence of disease activity in stable patients with relapsing-remitting multiple sclerosis (RRMS).

Major finding: 84% of study patients extended the dosing interval from the standard 4 weeks to a 5- to 7-week interval. No patient developed gadolinium-enhancing lesions (95% confidence interval [CI], 0-7.4%) during follow-up. No patient developed new/enlarging T2 lesions or relapses during the 1-year follow-up and 1-year extension phase.

Study details: The findings are based on a prospective, multicenter, single-arm trial of 61 patients with RRMS.

Disclosures: The study was funded by the Brain Foundation Netherlands. The presenting author had no disclosures. Some of the coauthors reported ties with pharmaceutical companies.

Citation: van Kempen ZLE et al. Neurology. 2020 Jul 20. doi: 10.1212/WNL.0000000000009995.

Key clinical point: Switching to personalized extended interval dosing of natalizumab did not result in recurrence of disease activity in stable patients with relapsing-remitting multiple sclerosis (RRMS).

Major finding: 84% of study patients extended the dosing interval from the standard 4 weeks to a 5- to 7-week interval. No patient developed gadolinium-enhancing lesions (95% confidence interval [CI], 0-7.4%) during follow-up. No patient developed new/enlarging T2 lesions or relapses during the 1-year follow-up and 1-year extension phase.

Study details: The findings are based on a prospective, multicenter, single-arm trial of 61 patients with RRMS.

Disclosures: The study was funded by the Brain Foundation Netherlands. The presenting author had no disclosures. Some of the coauthors reported ties with pharmaceutical companies.

Citation: van Kempen ZLE et al. Neurology. 2020 Jul 20. doi: 10.1212/WNL.0000000000009995.

Key clinical point: Switching to personalized extended interval dosing of natalizumab did not result in recurrence of disease activity in stable patients with relapsing-remitting multiple sclerosis (RRMS).

Major finding: 84% of study patients extended the dosing interval from the standard 4 weeks to a 5- to 7-week interval. No patient developed gadolinium-enhancing lesions (95% confidence interval [CI], 0-7.4%) during follow-up. No patient developed new/enlarging T2 lesions or relapses during the 1-year follow-up and 1-year extension phase.

Study details: The findings are based on a prospective, multicenter, single-arm trial of 61 patients with RRMS.

Disclosures: The study was funded by the Brain Foundation Netherlands. The presenting author had no disclosures. Some of the coauthors reported ties with pharmaceutical companies.

Citation: van Kempen ZLE et al. Neurology. 2020 Jul 20. doi: 10.1212/WNL.0000000000009995.

Key clinical point: Disease-modifying therapies (DMTs) are associated with improvements in disability outcomes in patients with active relapses during secondary progressive multiple sclerosis (SPMS).

Major finding: Patients who experienced superimposed relapses during SPMS and received DMTs had a greater proportion of time with a reduced Multiple Sclerosis Severity Score (MSSS) progression slope during SPMS (per 25% increase in proportion of time receiving treatment, β = −0.025; P less than .001 for low-efficacy; β = −0.022; P = .06 for medium-efficacy; and β = −0.034; P = .002 for high-efficacy therapies).

Study details: An observational cohort study of 1,621 patients with active SPMS from the international MSBase registry.

Disclosures: The study was supported by grants from the National Health and Medical Research Council. The MSBase Foundation receives funding from Bayer, bioCSL, Biogen, Merck, Novartis, Roche, and Sanofi Genzyme. The presenting author reported receiving travel compensation from Merck outside the submitted work.

Citation: Lizak N et al. JAMA Neurol. 2020 Jul 27. doi: 10.1001/jamaneurol.2020.2453.

Key clinical point: Disease-modifying therapies (DMTs) are associated with improvements in disability outcomes in patients with active relapses during secondary progressive multiple sclerosis (SPMS).

Major finding: Patients who experienced superimposed relapses during SPMS and received DMTs had a greater proportion of time with a reduced Multiple Sclerosis Severity Score (MSSS) progression slope during SPMS (per 25% increase in proportion of time receiving treatment, β = −0.025; P less than .001 for low-efficacy; β = −0.022; P = .06 for medium-efficacy; and β = −0.034; P = .002 for high-efficacy therapies).

Study details: An observational cohort study of 1,621 patients with active SPMS from the international MSBase registry.

Disclosures: The study was supported by grants from the National Health and Medical Research Council. The MSBase Foundation receives funding from Bayer, bioCSL, Biogen, Merck, Novartis, Roche, and Sanofi Genzyme. The presenting author reported receiving travel compensation from Merck outside the submitted work.

Citation: Lizak N et al. JAMA Neurol. 2020 Jul 27. doi: 10.1001/jamaneurol.2020.2453.

Key clinical point: Disease-modifying therapies (DMTs) are associated with improvements in disability outcomes in patients with active relapses during secondary progressive multiple sclerosis (SPMS).

Major finding: Patients who experienced superimposed relapses during SPMS and received DMTs had a greater proportion of time with a reduced Multiple Sclerosis Severity Score (MSSS) progression slope during SPMS (per 25% increase in proportion of time receiving treatment, β = −0.025; P less than .001 for low-efficacy; β = −0.022; P = .06 for medium-efficacy; and β = −0.034; P = .002 for high-efficacy therapies).

Study details: An observational cohort study of 1,621 patients with active SPMS from the international MSBase registry.

Disclosures: The study was supported by grants from the National Health and Medical Research Council. The MSBase Foundation receives funding from Bayer, bioCSL, Biogen, Merck, Novartis, Roche, and Sanofi Genzyme. The presenting author reported receiving travel compensation from Merck outside the submitted work.

Citation: Lizak N et al. JAMA Neurol. 2020 Jul 27. doi: 10.1001/jamaneurol.2020.2453.

Key clinical point: The follow-up of patients with progressive multiple sclerosis (PMS) starting high-dose biotin (HDB) should include careful assessment of clinical and radiological activity to monitor the potential pro-inflammatory effect of biotin.

Major finding: In the crossover analysis among patients who received HDB (n=42), the number of relapses was statistically and clinically significantly higher after vs. before biotin initiation (incident rate ratio, 7.4; P less than .0001). With the propensity score matching method, relapse risk was significantly higher in the biotin vs. control group (hazard ratio [HR], 4.3; P = .01). The inverse probability of treatment weighting method with 440 control participants showed consistent results with higher risk in the biotin group (HR, 5.1; P less than .0001).

Study details: This study evaluated the association between exposure to HDB and the risk of relapse among 482 patients with PMS.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Citation: Branger P et al. Neurotherapeutics. 2020 Jun 15. doi: 10.1007/s13311-020-00880-z.

Key clinical point: The follow-up of patients with progressive multiple sclerosis (PMS) starting high-dose biotin (HDB) should include careful assessment of clinical and radiological activity to monitor the potential pro-inflammatory effect of biotin.

Major finding: In the crossover analysis among patients who received HDB (n=42), the number of relapses was statistically and clinically significantly higher after vs. before biotin initiation (incident rate ratio, 7.4; P less than .0001). With the propensity score matching method, relapse risk was significantly higher in the biotin vs. control group (hazard ratio [HR], 4.3; P = .01). The inverse probability of treatment weighting method with 440 control participants showed consistent results with higher risk in the biotin group (HR, 5.1; P less than .0001).

Study details: This study evaluated the association between exposure to HDB and the risk of relapse among 482 patients with PMS.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Citation: Branger P et al. Neurotherapeutics. 2020 Jun 15. doi: 10.1007/s13311-020-00880-z.

Key clinical point: The follow-up of patients with progressive multiple sclerosis (PMS) starting high-dose biotin (HDB) should include careful assessment of clinical and radiological activity to monitor the potential pro-inflammatory effect of biotin.

Major finding: In the crossover analysis among patients who received HDB (n=42), the number of relapses was statistically and clinically significantly higher after vs. before biotin initiation (incident rate ratio, 7.4; P less than .0001). With the propensity score matching method, relapse risk was significantly higher in the biotin vs. control group (hazard ratio [HR], 4.3; P = .01). The inverse probability of treatment weighting method with 440 control participants showed consistent results with higher risk in the biotin group (HR, 5.1; P less than .0001).

Study details: This study evaluated the association between exposure to HDB and the risk of relapse among 482 patients with PMS.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Citation: Branger P et al. Neurotherapeutics. 2020 Jun 15. doi: 10.1007/s13311-020-00880-z.

Key clinical point: Age, disability, and obesity were independent risk factors for severe COVID-19 in patients with multiple sclerosis (MS).

Major finding: Higher age (odds ratio [OR] per 10 years, 1.9; 95% confidence interval [CI], 1.4-2.5), Expanded Disability Severity Status scores of ≥6 (OR, 6.3; 95% CI, 2.8-14.4), and obesity (OR, 3.0; 95% CI, 1.03-8.7) were independently associated with severe COVID-19 (severity score ≥3) Modification of disease-modifying therapies had no association with COVID-19 outcomes.

Study details: A multicenter, retrospective, observational cohort study analyzed data for 347 MS patients with confirmed or highly suspected COVID-19.

Disclosures: The study did not receive any specific funding. The authors reported relationships with multiple pharmaceutical companies and institutions.

Citation: Louapre C et al. JAMA Neurol. 2020 Jun 26. doi: 10.1001/jamaneurol.2020.2581.

Key clinical point: Age, disability, and obesity were independent risk factors for severe COVID-19 in patients with multiple sclerosis (MS).

Major finding: Higher age (odds ratio [OR] per 10 years, 1.9; 95% confidence interval [CI], 1.4-2.5), Expanded Disability Severity Status scores of ≥6 (OR, 6.3; 95% CI, 2.8-14.4), and obesity (OR, 3.0; 95% CI, 1.03-8.7) were independently associated with severe COVID-19 (severity score ≥3) Modification of disease-modifying therapies had no association with COVID-19 outcomes.

Study details: A multicenter, retrospective, observational cohort study analyzed data for 347 MS patients with confirmed or highly suspected COVID-19.

Disclosures: The study did not receive any specific funding. The authors reported relationships with multiple pharmaceutical companies and institutions.

Citation: Louapre C et al. JAMA Neurol. 2020 Jun 26. doi: 10.1001/jamaneurol.2020.2581.

Key clinical point: Age, disability, and obesity were independent risk factors for severe COVID-19 in patients with multiple sclerosis (MS).

Major finding: Higher age (odds ratio [OR] per 10 years, 1.9; 95% confidence interval [CI], 1.4-2.5), Expanded Disability Severity Status scores of ≥6 (OR, 6.3; 95% CI, 2.8-14.4), and obesity (OR, 3.0; 95% CI, 1.03-8.7) were independently associated with severe COVID-19 (severity score ≥3) Modification of disease-modifying therapies had no association with COVID-19 outcomes.

Study details: A multicenter, retrospective, observational cohort study analyzed data for 347 MS patients with confirmed or highly suspected COVID-19.

Disclosures: The study did not receive any specific funding. The authors reported relationships with multiple pharmaceutical companies and institutions.

Citation: Louapre C et al. JAMA Neurol. 2020 Jun 26. doi: 10.1001/jamaneurol.2020.2581.

Key clinical point: Treatment with rituximab could effectively reduce disability levels and relapse rates in patients with multiple sclerosis (MS).

Major finding: The mean Expanded Disability Status Scale (EDSS) scores decreased by 0.29 (95% confidence interval [CI], 0.16-0.42) after rituximab treatment. Analysis of 3 studies showed a mean reduction in annualized relapse rates (–1.24; 95% CI, –1.04 to –1.44) after rituximab treatment. The overall proportion of adverse effects was 23% (95% CI, 20%-26%).

Study details: A systematic review and meta-analysis of 7 studies including 399 patients with MS treated with rituximab.

Disclosures: No information was available on funding and conflicts of interest.

Citation: Ghajarzadeh M et al. Autoimmun Rev. 2020 Jun 10. doi:10.1016/j.autrev.2020.102585.

Key clinical point: Treatment with rituximab could effectively reduce disability levels and relapse rates in patients with multiple sclerosis (MS).

Major finding: The mean Expanded Disability Status Scale (EDSS) scores decreased by 0.29 (95% confidence interval [CI], 0.16-0.42) after rituximab treatment. Analysis of 3 studies showed a mean reduction in annualized relapse rates (–1.24; 95% CI, –1.04 to –1.44) after rituximab treatment. The overall proportion of adverse effects was 23% (95% CI, 20%-26%).

Study details: A systematic review and meta-analysis of 7 studies including 399 patients with MS treated with rituximab.

Disclosures: No information was available on funding and conflicts of interest.

Citation: Ghajarzadeh M et al. Autoimmun Rev. 2020 Jun 10. doi:10.1016/j.autrev.2020.102585.

Key clinical point: Treatment with rituximab could effectively reduce disability levels and relapse rates in patients with multiple sclerosis (MS).

Major finding: The mean Expanded Disability Status Scale (EDSS) scores decreased by 0.29 (95% confidence interval [CI], 0.16-0.42) after rituximab treatment. Analysis of 3 studies showed a mean reduction in annualized relapse rates (–1.24; 95% CI, –1.04 to –1.44) after rituximab treatment. The overall proportion of adverse effects was 23% (95% CI, 20%-26%).

Study details: A systematic review and meta-analysis of 7 studies including 399 patients with MS treated with rituximab.

Disclosures: No information was available on funding and conflicts of interest.

Citation: Ghajarzadeh M et al. Autoimmun Rev. 2020 Jun 10. doi:10.1016/j.autrev.2020.102585.

Key clinical point: The prevalence of enlarged perivascular spaces (EPVS) on magnetic resonance imaging is higher in patients with multiple sclerosis (MS), with higher EPVS burden vs. controls. This supports a potential role of EPVS in MS etiopathogenesis and its use as marker with prognostic potential.

Major finding: Whole brain EPVSs were more common in patients with MS vs. controls (odds ratio [OR], 4.61; P = .001). Patients with MS had a larger EPVS volume (standardized mean difference [SMD], 0.88; P = .01), area (SMD, 0.79; P = .06), and count (SMD, 0.46; P less than .0001) compared with controls.

Study details: Systematic review and meta-analysis of 9 studies including 457 patients with MS and 352 control participants.

Disclosures: This study was supported by grants of the Swiss National Science Foundation and the Region of Stockholm. The authors declared no conflict of interest.

Citation: Granberg T et al. J Neurol. 2020 Jun 13. doi: 10.1007/s00415-020-09971-5.

Key clinical point: The prevalence of enlarged perivascular spaces (EPVS) on magnetic resonance imaging is higher in patients with multiple sclerosis (MS), with higher EPVS burden vs. controls. This supports a potential role of EPVS in MS etiopathogenesis and its use as marker with prognostic potential.

Major finding: Whole brain EPVSs were more common in patients with MS vs. controls (odds ratio [OR], 4.61; P = .001). Patients with MS had a larger EPVS volume (standardized mean difference [SMD], 0.88; P = .01), area (SMD, 0.79; P = .06), and count (SMD, 0.46; P less than .0001) compared with controls.

Study details: Systematic review and meta-analysis of 9 studies including 457 patients with MS and 352 control participants.

Disclosures: This study was supported by grants of the Swiss National Science Foundation and the Region of Stockholm. The authors declared no conflict of interest.

Citation: Granberg T et al. J Neurol. 2020 Jun 13. doi: 10.1007/s00415-020-09971-5.

Key clinical point: The prevalence of enlarged perivascular spaces (EPVS) on magnetic resonance imaging is higher in patients with multiple sclerosis (MS), with higher EPVS burden vs. controls. This supports a potential role of EPVS in MS etiopathogenesis and its use as marker with prognostic potential.

Major finding: Whole brain EPVSs were more common in patients with MS vs. controls (odds ratio [OR], 4.61; P = .001). Patients with MS had a larger EPVS volume (standardized mean difference [SMD], 0.88; P = .01), area (SMD, 0.79; P = .06), and count (SMD, 0.46; P less than .0001) compared with controls.

Study details: Systematic review and meta-analysis of 9 studies including 457 patients with MS and 352 control participants.

Disclosures: This study was supported by grants of the Swiss National Science Foundation and the Region of Stockholm. The authors declared no conflict of interest.

Citation: Granberg T et al. J Neurol. 2020 Jun 13. doi: 10.1007/s00415-020-09971-5.

Key clinical point: Treatment with hookworm was safe and possibly associated with an immunobiological effect in relapsing multiple sclerosis.

Major finding: During 3-9 months postinfection, no significant difference was detected between hookworm and placebo groups in total number of new T2 lesions, newly enhancing T1-weighted lesions, or T2 enlarging lesions. Hookworm group was somewhat less likely to have any magnetic resonance imaging activity (odds ratio, 0.33), higher percentage of CD4+CD25^highCD127^negT cells in peripheral blood (4.4% vs. 3.9%; P = .01), and lower relapse rate per patient (14.3% vs. 30.6%). No patients withdrew because of adverse effects. The only differing adverse event was more application-site skin discomfort in the hookworm group (82.86% vs. 27.78%).

Study details: In this phase 2 trial, 71 patients with relapsing MS without disease-modifying treatment were randomly assigned (1:1) to receive 25 Necator americanus larvae transcutaneously or placebo.

Disclosures: This study was supported by the MS Society of the Great Britain and Northern Ireland, the Forman Hardy Charitable Trust via the University of Nottingham, and an unrestricted grant from Bayer-Schering. Some of the investigators reported receiving grants and personal fees from multiple pharmaceutical companies.

Citation: Tanasescu R et al. JAMA Neurol. 2020 Jun 15. doi: 10.1001/jamaneurol.2020.1118.

Key clinical point: Treatment with hookworm was safe and possibly associated with an immunobiological effect in relapsing multiple sclerosis.

Major finding: During 3-9 months postinfection, no significant difference was detected between hookworm and placebo groups in total number of new T2 lesions, newly enhancing T1-weighted lesions, or T2 enlarging lesions. Hookworm group was somewhat less likely to have any magnetic resonance imaging activity (odds ratio, 0.33), higher percentage of CD4+CD25^highCD127^negT cells in peripheral blood (4.4% vs. 3.9%; P = .01), and lower relapse rate per patient (14.3% vs. 30.6%). No patients withdrew because of adverse effects. The only differing adverse event was more application-site skin discomfort in the hookworm group (82.86% vs. 27.78%).

Study details: In this phase 2 trial, 71 patients with relapsing MS without disease-modifying treatment were randomly assigned (1:1) to receive 25 Necator americanus larvae transcutaneously or placebo.

Disclosures: This study was supported by the MS Society of the Great Britain and Northern Ireland, the Forman Hardy Charitable Trust via the University of Nottingham, and an unrestricted grant from Bayer-Schering. Some of the investigators reported receiving grants and personal fees from multiple pharmaceutical companies.

Citation: Tanasescu R et al. JAMA Neurol. 2020 Jun 15. doi: 10.1001/jamaneurol.2020.1118.

Key clinical point: Treatment with hookworm was safe and possibly associated with an immunobiological effect in relapsing multiple sclerosis.

Major finding: During 3-9 months postinfection, no significant difference was detected between hookworm and placebo groups in total number of new T2 lesions, newly enhancing T1-weighted lesions, or T2 enlarging lesions. Hookworm group was somewhat less likely to have any magnetic resonance imaging activity (odds ratio, 0.33), higher percentage of CD4+CD25^highCD127^negT cells in peripheral blood (4.4% vs. 3.9%; P = .01), and lower relapse rate per patient (14.3% vs. 30.6%). No patients withdrew because of adverse effects. The only differing adverse event was more application-site skin discomfort in the hookworm group (82.86% vs. 27.78%).

Study details: In this phase 2 trial, 71 patients with relapsing MS without disease-modifying treatment were randomly assigned (1:1) to receive 25 Necator americanus larvae transcutaneously or placebo.

Disclosures: This study was supported by the MS Society of the Great Britain and Northern Ireland, the Forman Hardy Charitable Trust via the University of Nottingham, and an unrestricted grant from Bayer-Schering. Some of the investigators reported receiving grants and personal fees from multiple pharmaceutical companies.

Citation: Tanasescu R et al. JAMA Neurol. 2020 Jun 15. doi: 10.1001/jamaneurol.2020.1118.

Key clinical point: Patients with multiple sclerosis (MS) in the United States (US) and the United Kingdom (UK) have a 2- to 3-fold higher incidence of depression than those without MS.

Major finding: A significantly higher incidence of depression was observed among patients with MS vs. non-MS control individuals in the US (incidence rate ratio [IRR], 3.20; 95% confidence interval [CI], 3.05-3.35) and the UK (IRR, 1.90; 95% CI, 1.74-2.06).

Study details: This cohort study included individuals with a first recorded diagnosis of MS and matched non-MS individuals identified from the US Department of Defense military healthcare system and the UK’s Clinical Practice Research Datalink GOLD.

Disclosures: The study was funded by Celgene Corporation, a wholly owned subsidiary of Bristol-Myers Squibb. Sally Lee, Neil Minton, Steve Niemcryk, and Anders Lindholm are employees of Bristol-Myers Squibb. Amber M Evans is an employee of Health ResearchTx LLC, which has a business relationship with Celgene Corporation.

Citation: Persson R et al. Eur J Neurol. 2020 May 12. doi: 10.1111/ene.14314.

Key clinical point: Patients with multiple sclerosis (MS) in the United States (US) and the United Kingdom (UK) have a 2- to 3-fold higher incidence of depression than those without MS.

Major finding: A significantly higher incidence of depression was observed among patients with MS vs. non-MS control individuals in the US (incidence rate ratio [IRR], 3.20; 95% confidence interval [CI], 3.05-3.35) and the UK (IRR, 1.90; 95% CI, 1.74-2.06).

Study details: This cohort study included individuals with a first recorded diagnosis of MS and matched non-MS individuals identified from the US Department of Defense military healthcare system and the UK’s Clinical Practice Research Datalink GOLD.

Disclosures: The study was funded by Celgene Corporation, a wholly owned subsidiary of Bristol-Myers Squibb. Sally Lee, Neil Minton, Steve Niemcryk, and Anders Lindholm are employees of Bristol-Myers Squibb. Amber M Evans is an employee of Health ResearchTx LLC, which has a business relationship with Celgene Corporation.

Citation: Persson R et al. Eur J Neurol. 2020 May 12. doi: 10.1111/ene.14314.

Key clinical point: Patients with multiple sclerosis (MS) in the United States (US) and the United Kingdom (UK) have a 2- to 3-fold higher incidence of depression than those without MS.

Major finding: A significantly higher incidence of depression was observed among patients with MS vs. non-MS control individuals in the US (incidence rate ratio [IRR], 3.20; 95% confidence interval [CI], 3.05-3.35) and the UK (IRR, 1.90; 95% CI, 1.74-2.06).

Study details: This cohort study included individuals with a first recorded diagnosis of MS and matched non-MS individuals identified from the US Department of Defense military healthcare system and the UK’s Clinical Practice Research Datalink GOLD.

Disclosures: The study was funded by Celgene Corporation, a wholly owned subsidiary of Bristol-Myers Squibb. Sally Lee, Neil Minton, Steve Niemcryk, and Anders Lindholm are employees of Bristol-Myers Squibb. Amber M Evans is an employee of Health ResearchTx LLC, which has a business relationship with Celgene Corporation.

Citation: Persson R et al. Eur J Neurol. 2020 May 12. doi: 10.1111/ene.14314.

Key clinical point: Inflammatory activity declines with age in patients with multiple sclerosis (MS), as evidenced by decreased gadolinium enhancement with advancing age.

Major finding: The odds for gadolinium enhancement decreased with advancing age up to 60 years (31-40 years: odds ratio [OR], 0.55; 41-50 years: OR, 0.42; and 51-60 years: OR, 0.24; P less than .0001 for all).

Study details: A cohort study of 1,543 patients with clinically isolated syndrome and MS assessed the association of risk factors, including age, with gadolinium enhancement on cranial magnetic resonance imaging scans.

Disclosures: The study did not receive any funding. Marcus W Koch and Wei-Qiao Liu reported relationships with multiple pharmaceutical companies. Jop Mostert, Jamie Greenfield, and Prof Luanne Metz have declared no conflicts of interest.

Citation: Koch MW et al. J Neurol. 2020 May 09. doi: 10.1007/s00415-020-09895-0.

Key clinical point: Inflammatory activity declines with age in patients with multiple sclerosis (MS), as evidenced by decreased gadolinium enhancement with advancing age.

Major finding: The odds for gadolinium enhancement decreased with advancing age up to 60 years (31-40 years: odds ratio [OR], 0.55; 41-50 years: OR, 0.42; and 51-60 years: OR, 0.24; P less than .0001 for all).

Study details: A cohort study of 1,543 patients with clinically isolated syndrome and MS assessed the association of risk factors, including age, with gadolinium enhancement on cranial magnetic resonance imaging scans.

Disclosures: The study did not receive any funding. Marcus W Koch and Wei-Qiao Liu reported relationships with multiple pharmaceutical companies. Jop Mostert, Jamie Greenfield, and Prof Luanne Metz have declared no conflicts of interest.

Citation: Koch MW et al. J Neurol. 2020 May 09. doi: 10.1007/s00415-020-09895-0.

Key clinical point: Inflammatory activity declines with age in patients with multiple sclerosis (MS), as evidenced by decreased gadolinium enhancement with advancing age.

Major finding: The odds for gadolinium enhancement decreased with advancing age up to 60 years (31-40 years: odds ratio [OR], 0.55; 41-50 years: OR, 0.42; and 51-60 years: OR, 0.24; P less than .0001 for all).

Study details: A cohort study of 1,543 patients with clinically isolated syndrome and MS assessed the association of risk factors, including age, with gadolinium enhancement on cranial magnetic resonance imaging scans.

Disclosures: The study did not receive any funding. Marcus W Koch and Wei-Qiao Liu reported relationships with multiple pharmaceutical companies. Jop Mostert, Jamie Greenfield, and Prof Luanne Metz have declared no conflicts of interest.

Citation: Koch MW et al. J Neurol. 2020 May 09. doi: 10.1007/s00415-020-09895-0.

Key clinical point: Dimethyl fumarate (DMF) may slow down cognitive impairment in patients with relapsing-remitting multiple sclerosis (RRMS).

Major finding: Of 34 patients with cognitive impairment at baseline, 55.9% of patients did not show evidence of cognitive worsening at 2 years.

Study details: This prospective single-arm study enrolled patients with RRMS (n=217) treated with DMF for 2 years.

Disclosures: This study was funded by Biogen. The authors reported relationships with multiple pharmaceutical companies.

Citation: Amato MP et al. Neurol Sci. 2020 May 01. doi: 10.1007/s10072-020-04320-w.

Key clinical point: Dimethyl fumarate (DMF) may slow down cognitive impairment in patients with relapsing-remitting multiple sclerosis (RRMS).

Major finding: Of 34 patients with cognitive impairment at baseline, 55.9% of patients did not show evidence of cognitive worsening at 2 years.

Study details: This prospective single-arm study enrolled patients with RRMS (n=217) treated with DMF for 2 years.

Disclosures: This study was funded by Biogen. The authors reported relationships with multiple pharmaceutical companies.

Citation: Amato MP et al. Neurol Sci. 2020 May 01. doi: 10.1007/s10072-020-04320-w.

Key clinical point: Dimethyl fumarate (DMF) may slow down cognitive impairment in patients with relapsing-remitting multiple sclerosis (RRMS).

Major finding: Of 34 patients with cognitive impairment at baseline, 55.9% of patients did not show evidence of cognitive worsening at 2 years.

Study details: This prospective single-arm study enrolled patients with RRMS (n=217) treated with DMF for 2 years.

Disclosures: This study was funded by Biogen. The authors reported relationships with multiple pharmaceutical companies.

Citation: Amato MP et al. Neurol Sci. 2020 May 01. doi: 10.1007/s10072-020-04320-w.