The recent TOPIC trial found that teriflunomide could prevent relapses in patients with clinically isolated syndrome (CIS). Many other multiple sclerosis (MS) therapies are effective for CIS, because CIS is the first clinical manifestation of MS for most patients. Questions remain over the utility of future trials like TOPIC.
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References
Miller, A. E. et al. Oral teriflunomide for patients with a first clinical episode suggestive of multiple sclerosis (TOPIC): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Neurol. 13, 977–986 (2014).
Jacobs, L. D. et al. Intramuscular interferon beta-1a therapy initiated during a first demyelinating event in multiple sclerosis. CHAMPS Study Group. N. Engl. J. Med. 343, 898–904 (2000).
Kappos, L. et al. Treatment with interferon beta-1b delays conversion to clinically definite and McDonald MS in patients with clinically isolated syndromes. Neurology 67, 1242–1249 (2006).
Comi, G. et al. Effect of glatiramer acetate on conversion to clinically definite multiple sclerosis in patients with clinically isolated syndrome (PreCISe study): a randomised, double-blind, placebo-controlled trial. Lancet 374, 1503–1511 (2009).
Comi, G. et al. Comparison of two dosing frequencies of subcutaneous interferon beta-1a in patients with a first clinical demyelinating event suggestive of multiple sclerosis (REFLEX): a phase 3 randomised controlled trial. Lancet Neurol. 11, 33–41 (2012).
Leist, T. P. et al. Effect of oral cladribine on time to conversion to clinically definite multiple sclerosis in patients with a first demyelinating event (ORACLE MS): a phase 3 randomised trial. Lancet Neurol. 13, 257–267 (2014).
Morrissey, S. P. et al. The significance of brain magnetic resonance imaging abnormalities at presentation with clinically isolated syndromes suggestive of multiple sclerosis. A 5-year follow-up study. Brain 116, 135–146 (1993).
Brex, P. A. et al. A longitudinal study of abnormalities on MRI and disability from multiple sclerosis. N. Engl. J. Med. 346, 158–164 (2002).
Montalban, X. et al. MRI criteria for MS in patients with clinically isolated syndromes. Neurology 74, 427–434 (2010).
Fisniku, L. K. et al. Disability and T2 MRI lesions: a 20-year follow-up of patients with relapse onset of multiple sclerosis. Brain 131, 808–817 (2008).
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B.C. has received personal compensation for consulting from Abbvie, Biogen Idec, EMD Serono, Genzyme/Sanofi Aventis, MedImmune, Novartis and Teva Neurosciences. He has received research support (including for clinical trials) from Acorda, Avanir, Biogen Idec, EMD Serono, Hoffman La Roche, MedImmune and Teva Neurosciences.
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Cree, B. Is TOPIC the last trial for clinically isolated syndrome?. Nat Rev Neurol 11, 6–7 (2015). https://doi.org/10.1038/nrneurol.2014.239
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DOI: https://doi.org/10.1038/nrneurol.2014.239
