Table 1.
Demographic, clinical, MRI and CSF characteristics.
| Total | Non-CDMS converter | N | CDMS converter | n | P value | |
|---|---|---|---|---|---|---|
| Baseline | ||||||
| Age (years), mean ± SD | 33 ± 10 | 35 ± 11 | 50 | 31 ± 8 | 36 | 0.051f |
| Sex (female), n (%) | 59 (67) | 29 (58) | 50 | 30 (83) | 36 | 0.018g |
| Monofocal syndrome, n (%) | 82 (95) | 48 (96) | 50 | 34 (94) | 36 | 0.735g |
| Optic neuritis, n (%)a | 25 (29) | 13 (27) | 48 | 12 (35) | 34 | 0.426g |
| Myelitis, n (%)a | 37 (43) | 24 (50) | 48 | 13 (38) | 34 | 0.292g |
| Brainstem/cerebellum, n (%)a | 19 (22) | 10 (21) | 48 | 9 (26) | 34 | 0.551g |
| Other cerebral symptom, n (%)a | 1 (1) | 1 (2) | 48 | 0 (0) | 34 | 0.397g |
| Disease duration (days)b | 13 (5–38) | 18 (7–60) | 50 | 8 (3–21) | 36 | 0.006h |
| No corticosteroid treatment before LP, n (%) | 55 (70) | 34 (77) | 44 | 21 (60) | 35 | 0.357g |
| Brain MRI | ||||||
| Number of T2 hyperintense lesions | 10 (3–17) | 8 (3–15) | 47 | 10 (7–20) | 33 | 0.044h |
| Number of T1 contrast-enhancing lesions | 1 (0–2) | 0 (0–1) | 44 | 2 (0–3) | 27 | 0.003h |
| Dissemination in space, n (%)c | 58 (73) | 31 (66) | 47 | 27 (83) | 33 | 0.135g |
| Dissemination in time, n (%)c | 39 (55) | 19 (43) | 44 | 20 (76) | 27 | 0.014g |
| Field strength (1.5 T), n (%) | 69 (86) | 39 (83) | 47 | 30 (91) | 33 | 0.311g |
| Cerebrospinal fluid analysis | ||||||
| RBC count (/μl) | 0 (0–2) | 0 (0–8) | 48 | 0 (0–1) | 35 | 0.552h |
| WBC count (/μl) | 5 (3–12) | 5 (3–12) | 48 | 6 (3–12) | 35 | 0.644h |
| Oligoclonal IgG bands, n (%) | 77 (90) | 43 (86) | 50 | 34 (94) | 36 | 0.207g |
| CSF κ-FLC (mg/l) | 1.91 (0.68–4.99) | 1.75 (0.67–3.78) | 50 | 2.79 (0.74–6.67) | 36 | 0.093h |
| Serum κ-FLC (mg/l) | 11.60 (9.47–15.50) | 11.40 (9.53–15.50) | 50 | 11.75 (9.22–15.35) | 36 | 0.920h |
| CSF NfL (pg/ml) | 895 (475–1704) | 752 (476–1261) | 47 | 1226 (444–2140) | 34 | 0.177h |
| Serum NfL (pg/ml) | 13.8 (8.4–22.7) | 12.6 (8.3–18.4) | 45 | 18.7 (9.1–30.4) | 33 | 0.040h |
| Fulfillment of McDonald criteria 2017 at baseline, n (%) | 61 (76) | 33 (70) | 47 | 28 (85) | 33 | 0.130g |
| Follow-up | ||||||
| Follow-up duration (months) | 47 (38–48) | 43.6 (35.5–48.0) | 50 | 47.9 (47.0–48.9) | 36 | <0.001h |
| Disease modifying treatment | ||||||
| DMT start before second attack in CDMS converter, or until end of FU in non-CDMS converter, n (%) | 20 (23) | 11 (22) | 50 | 9 (25)d | 36 | 0.745g |
| Time to DMT start (months) | 7.0 (3.7–8.4) | 7.4 (3.0–11.2) | 11 | 6.9 (3.8–7.9) | 9 | 0.824h |
| Duration of DMT before second attack (months) | 9.0 (5.5–12.6) | 9 | ||||
| Clinical attacks | ||||||
| Time to second attack (months)e | 11.4 (5.1–23.2) | 36 | ||||
| Time to second attack in treated patients (months)e | 18.0 (13.7–24.3) | 9 | ||||
| Time to second attack in non-treated patients (months)e | 10.6 (3.1–22.1) | 27 | ||||
| Number of attacks until end of FU | 0 (0–2) | 2 (1–3) | 36 | <0.001h | ||
| Disability | ||||||
| EDSS score ≥3.0 at yr 1, n (%) | 3 (4) | 2 (5) | 44 | 1 (3) | 31 | 0.774g |
| EDSS score ≥3.0 at yr 2, n (%) | 6 (9) | 2 (6) | 36 | 4 (13) | 32 | 0.314g |
| EDSS score ≥3.0 at yr 3/4 (LCF), n (%) | 7 (8) | 2 (4) | 50 | 5 (15) | 34 | 0.081g |
Data are shown as median and interquartile range unless specified otherwise.
CDMS, clinically definite multiple sclerosis; CSF, cerebrospinal fluid; DMT, disease-modifying treatment; EDSS, Expanded Disability Status Scale; FLC, free light chain; FU, follow-up; LCF, last carried forward; LP, lumbar puncture; MRI, magnetic resonance imaging; NfL, Neurofilament Light; Qalb, CSF/serum albumin quotient; RBC, red blood cell; SD, standard deviation; WBC, white blood cell.
Frequencies (%) are shown for patients with monofocal syndrome only.
Disease duration is the time between disease onset and lumbar puncture.
Dissemination in space and time was demonstrated by MRI as defined in Thompson et al. Lancet Neurology 2018; 17 (2):162–173.
DMT administered before the occurrence of a second clinical attack comprised intramuscular Interferon-β-1a (n = 4), glatiramer acetate (n = 2), dimethyl fumarate (n = 1), and consecutively given teriflunomide, dimethyl fumarate (n = 1) as well as glatiramer acetate, dimethyl fumarate (n = 1).
Time is calculated from disease onset.
Independent t test was applied.
Pearson Chi quadrat or Fisher's test were applied.
Mann Whitney U test was applied.