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Evolution of MS lesions to black holes under DNA vaccine treatment

Papadopoulou, Athina ; von Felten, Stefanie ; Traud, Stefan ; Rahman, Amena ; Quan, Joanne ; King, Robert ; Garren, Hideki ; Steinman, Lawrence ; Cutter, Gary ; Kappos, Ludwig ; Radue, Ernst

In: Journal of Neurology, 2012, vol. 259, no. 7, p. 1375-1382

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    Titre
    • Evolution of MS lesions to black holes under DNA vaccine treatment
    Auteur
    • Papadopoulou, Athina. Neurology Clinic, Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
    • von Felten, Stefanie. Clinical Trial Unit, University Hospital Basel, Basel, Switzerland
    • Traud, Stefan. Medical Image Analysis Center (MIAC), University Hospital Basel, Basel, Switzerland
    • Rahman, Amena. Bayhill Therapeutics, Palo Alto, CA, USA
    • Quan, Joanne. Bayhill Therapeutics, Palo Alto, CA, USA
    • King, Robert. Bayhill Therapeutics, Palo Alto, CA, USA
    • Garren, Hideki. Bayhill Therapeutics, Palo Alto, CA, USA
    • Steinman, Lawrence. Stanford University, Stanford, USA
    • Cutter, Gary. Department of Biostatistics, University of Alabama, Birmingham, USA
    • Kappos, Ludwig. Neurology Clinic, Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
    • Radue, Ernst. Medical Image Analysis Center (MIAC), University Hospital Basel, Basel, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:317798
    Summary
    Persistent black holes (PBH) are associated with axonal loss and disability progression in multiple sclerosis (MS). The objective of this work was to determine if BHT-3009, a DNA plasmid-encoding myelin basic protein (MBP), reduces the risk of new lesions becoming PBH, compared to placebo, and to test if pre-treatment serum anti-MBP antibody levels impact on the effect of BHT-3009 treatment. In this retrospective, blinded MRI study, we reviewed MRI scans of 155 MS patients from a double-blind, randomized, phase II trial with three treatment arms (placebo, 0.5 and 1.5mg BHT-3009). New lesions at weeks 8 and 16 were tracked at week 48 and those appearing as T1-hypointense were classified as PBH. A subset of 46 patients with available pre-treatment serum anti-MBP IgM levels were analyzed separately. Overall, there was no impact of treatment on the risk for PBH. However, there was a significant interaction between anti-MBP antibodies and treatment effect: patients receiving 0.5mg BHT-3009 showed a reduced risk of PBH with higher antibody levels compared to placebo (p<0.01). Although we found no overall reduction of the risk for PBH in treated patients, there may be an effect of low-dose BHT-3009, depending on the patients' pre-treatment immune responses