Romeo M, Martinelli V, Rodegher M, Perego E, Maida S, Sormani M P, Comi G
Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy.
Eur J Neurol. 2015 Jun;22(6):973-80. doi: 10.1111/ene.12695. Epub 2015 Apr 6.
The Rio score (RS) and the modified Rio score (MRS) are two scoring systems that can identify the early predictive factors of disability progression in relapsing-remitting multiple sclerosis (RRMS) patients treated with interferon-β (IFN-β). The objective of the study was to validate the usefulness of the RS and MRS in a large cohort of multiple sclerosis patients treated with IFN-β in daily clinical practice.
The analysis included a cohort of RRMS patients treated with different formulations of IFN-β for at least 1 year. The RS and MRS were used to classify the patients after 1 year of treatment. Multivariate analysis was performed to identify predictive variables of suboptimal response at 5 years, defined as Expanded Disability Status Scale confirmed progression or switching to a second-line therapy.
Sixty-nine of 416 included patients were considered as suboptimal responders at 5-year evaluation. The possible score range was 0-3. A higher risk of suboptimal response was found for RS and MRS in the presence of ≥2 scores (hazard ratio 3.0, P = 0.002, and hazard ratio 5.0, P < 0.0001, respectively).
Our study confirmed, in a daily clinical setting, that MRS had a better specificity and accuracy than RS in identifying the patients who will have a poor response to long-term IFN-β treatment.
里约评分(RS)和改良里约评分(MRS)是两种评分系统,可用于识别接受干扰素-β(IFN-β)治疗的复发缓解型多发性硬化症(RRMS)患者残疾进展的早期预测因素。本研究的目的是在日常临床实践中,验证RS和MRS在一大群接受IFN-β治疗的多发性硬化症患者中的有效性。
分析纳入了一组接受不同剂型IFN-β治疗至少1年的RRMS患者。在治疗1年后,使用RS和MRS对患者进行分类。进行多变量分析以确定5年时反应欠佳的预测变量,反应欠佳定义为扩展残疾状态量表确认病情进展或改用二线治疗。
在416例纳入患者中,69例在5年评估时被视为反应欠佳者。可能的评分范围为0至3分。当RS和MRS评分≥2分时,出现反应欠佳的风险更高(风险比分别为3.0,P = 0.002;以及5.0,P < 0.0001)。
我们的研究在日常临床环境中证实,在识别对长期IFN-β治疗反应不佳的患者方面,MRS比RS具有更好的特异性和准确性。