Ten-Year Followup of People with Suspicious MRIs without MS Symptoms (“RIS”) Suggests Half Develop MS

In a global study of 451 people described as having “radiologically isolated syndrome” (RIS, a rare phenomenon in which people with no symptoms of MS have MRI scans that show specific areas of MS-like damage), 51.2% went on to develop MS within ten years. Several factors made some more likely to develop MS, so further defining these factors should help guide decisions about whether treating specific people with RIS is justified. Trials are now underway in people with RIS to determine if disease-modifying therapies will prevent or delay the development of MS. 

• A global team of collaborators has been tracking people with RIS to see which go on to develop MS, and whether there is a way to predict this outcome in advance to guide treatment decisions.
• In this study, factors associated with increased risk of later developing MS included younger age, having signs of spinal fluid proteins known as “oligoclonal bands,” having MRI lesions in the spinal cord or lower back part of the brain (infratentorial), and newly active lesions on follow-up MRI scans.
• Trials underway or planned in people with RIS include one testing teriflunomide (Aubagio®, Genzyme Sanofi) that is recruiting outside of the U.S., one testing dimethyl fumarate (Tecfidera®, Biogen) that is ongoing and no longer recruiting, and one testing a tuberculosis vaccine that is planned in Italy.

 “Radiologically Isolated Syndrome: 10‐Year Risk Estimate of a Clinical Event” by Christine Lebrun‐Frenay MD, PhD (Nice Cote d’Azur University) and colleagues was published June 4, 2020 in Annals of Neurology.