Publications by authors named "Jordi Rio"
Background: Predicting treatment response and disease progression in multiple sclerosis (MS) is challenging. Treatment Response Scoring Systems (TRSS) are potentially useful, but their utility in patients receiving high-efficacy therapies and very high-efficacy therapies (HET/vHET) remains unclear.
Objective: This study aimed to evaluate the performance of TRSS in patients treated with HET/vHET.
Background: It is essential to exclude alternative diagnoses to diagnose multiple sclerosis (MS). However, detailed descriptions of alternative diagnoses in patients with suspected MS presenting with clinically isolated syndrome (CIS) are limited.
Objectives: To describe alternative diagnoses in patients presenting with CIS suggestive of MS.
Background And Objectives: Emerging concepts in the early detection of multiple sclerosis (MS) progression reveal that disability accumulation can start early in the disease course. Aging in MS is increasingly recognized as a key factor for disease progression and disability accrual. We evaluate the prognostic impact of age in a cohort of patients experiencing a first demyelinating event (FDE), using a variety of disability outcomes, including some not previously assessed in age-specific studies.
View Article and Find Full Text PDFContribution of Blood Biomarkers to Multiple Sclerosis Diagnosis.
Neurol Neuroimmunol Neuroinflamm
March 2025
Background And Objectives: Invasive procedures may delay the diagnostic process in multiple sclerosis (MS). We investigated the added value of serum neurofilament light chain (sNfL), glial fibrillary acidic protein (sGFAP), chitinase-3-like 1 (sCHI3L1), and the immune responses to the Epstein-Barr virus-encoded nuclear antigen 1 to current MS diagnostic criteria.
Methods: In this multicentric study, we selected patients from 2 prospective cohorts presenting a clinically isolated syndrome (CIS).
Article Synopsis
- - Organizing pneumonia (OP) has been identified in patients with inflammatory demyelinating diseases (IDDs) after COVID-19, particularly those treated with anti-CD20 therapies, but comprehensive data is scarce.
- - This study analyzed 19 patients with conditions like multiple sclerosis and neuromyelitis optica who developed COVID-19-associated OP; symptoms included intermittent fever, and most required hospitalization, but none died.
- - After about 1.5 years of follow-up, most lung issues resolved, although many patients experienced long-COVID symptoms; the study suggests that OP should be considered in anti-CD20-treated patients exhibiting specific CT findings and fever.
Background: This meta-analysis aimed to assess the treatment effects of immunotherapies in subgroups of adults with clinically isolated syndrome or relapsing forms of multiple sclerosis (MS) and the effect of potential treatment effect modifiers (TEMs).
Methods: Phase 2 and 3 RCTs with a placebo comparator were analyzed. Risk of bias was assessed.
Recent advances in multiple sclerosis (MS) management have shifted perspectives on treatment strategies, advocating for the early initiation of high-efficacy disease-modifying therapies (heDMTs). This perspective review discusses the rationale, benefits, and challenges associated with early heDMT initiation, reflecting on the obsolescence of the traditional "first-line" and "second-line" treatment classifications. The article emerges from the last update of the consensus document of the Spanish Society of Neurology on the treatment of MS.
View Article and Find Full Text PDFBackground: People with secondary progressive multiple sclerosis (pwSPMS) experience increasing disability, which impacts negatively on their health-related quality of life (HRQoL). Our aims were to assess the impact of secondary progressive multiple sclerosis (SPMS) on functional status and HRQoL and describe the clinical profile in this population.
Methods: DISCOVER is an observational, cross-sectional, multicenter study with retrospective data collection in real-world clinical practice in Spain.
Importance: Vaccination in patients with highly active multiple sclerosis (MS) requiring prompt treatment initiation may result in impaired vaccine responses and/or treatment delay.
Objective: To assess the immunogenicity and safety of inactivated vaccines administered during natalizumab treatment.
Design, Setting, And Participants: This self-controlled, prospective cohort study followed adult patients with MS from 1 study center in Spain from September 2016 to February 2022.
Background: Limited data exist regarding treatment response prediction to oral disease-modifying therapies (DMTs) in multiple sclerosis (MS).
Objectives: We assessed the capacity of available scoring systems to anticipate disease activity parameters in naïve relapsing-remitting MS (RRMS) patients initiating daily oral DMTs, hypothesizing that they exhibit different predictive potentials.
Methods: We conducted a retrospective study and applied the Rio Score (RS), modified Rio Score (mRS), and MAGNIMS Score 12 months after DMT initiation.
Background And Objectives: We aimed to assess the presence of retinal neurodegeneration independent of optic neuritis (ON) in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and to investigate the development of trans-synaptic anterograde degeneration in these patients after ON.
Methods: Cross-sectional, retrospective study of 34 adult patients with MOGAD and 23 healthy controls (HC). Clinical, optical coherence tomography (OCT), and MRI data were collected.
Background: The combination of anatomical MRI and deep learning-based methods such as convolutional neural networks (CNNs) is a promising strategy to build predictive models of multiple sclerosis (MS) prognosis. However, studies assessing the effect of different input strategies on model's performance are lacking.
Purpose: To compare whole-brain input sampling strategies and regional/specific-tissue strategies, which focus on a priori known relevant areas for disability accrual, to stratify MS patients based on their disability level.
Assessing treatment response to oral drugs for multiple sclerosis in real-world setting: a MAGNIMS Study.
J Neurol Neurosurg Psychiatry
January 2024
Background: The assessment of treatment response is a crucial step for patients with relapsing-remitting multiple sclerosis on disease-modifying therapies (DMTs). We explored whether a scoring system developed within the MAGNIMS (MRI in Multiple Sclerosis) network to evaluate treatment response to injectable drugs can be adopted also to oral DMTs.
Methods: A multicentre dataset of 1200 patients who started three oral DMTs (fingolimod, teriflunomide and dimethyl fumarate) was collected within the MAGNIMS network.
Background And Purpose: The aim was to evaluate whether magnetic resonance imaging (MRI) phenotypes defined by inflammation and neurodegeneration markers correlate with serum levels of neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) in relapsing-remitting multiple sclerosis (RRMS) patients; and to explore the role of radiological phenotypes and biomarker levels on treatment response and long-term prognostic outcomes.
Methods: Magnetic resonance imaging scans from 80 RRMS patients were classified at baseline of interferon-beta (IFNβ) treatment into radiological phenotypes defined by high and low inflammation and high and low neurodegeneration, based on the number of contrast-enhancing lesions, brain parenchymal fraction and the relative volume of non-enhancing black holes on T1-weighted images. Serum levels of NfL and GFAP were measured at baseline with single molecule array (Simoa) assays.
Background: Mumps-Measles-Rubella (MMR) and Varicella zoster vaccines (VAR) are live attenuated vaccines, usually administered in a two-dose scheme at least 4 weeks apart. However, single-dose immunization schemes may also be effective and can reduce delays in immunosuppressive treatment initiation in patients with multiple sclerosis (pwMS) who need to be immunized.
Objectives: To evaluate the immunogenicity of a single-dose attempt (SDA) versus the standard immunization scheme (SIS) with VAR and/or MMR in pwMS.
Objective: Myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) distinguish multiple sclerosis (MS) from MOG-associated disease in most cases. However, studies analyzing MOG-Ab at the time of a first demyelinating event suggestive of MS in adults are lacking. We aimed to (1) evaluate the prevalence of MOG-Ab in a first demyelinating event suggestive of MS and (2) compare clinical and paraclinical features between seropositive (MOG-Ab+) and seronegative (MOG-Ab-) patients.
View Article and Find Full Text PDFArticle Synopsis
- Early treatment after a first demyelinating event is linked to improved long-term outcomes in patients with multiple sclerosis (MS), but MR findings are often overlooked when evaluating these outcomes.
- The study analyzed data from 580 patients between 1994 and 2021, categorizing them based on how soon they received disease-modifying drugs (DMDs) after their first event, creating a 5-point MR score (MRS) to assess disability risk.
- Results showed that very early treatment significantly reduced the risk of developing severe disability and secondary progressive MS compared to those who started treatment later, highlighting the importance of timely intervention and MR score in treatment decisions.
Article Synopsis
- The study investigates the role of the NLRP3 inflammasome in the response to the MS treatment fingolimod, known to potentially inhibit its activation.
- Using real-time PCR, researchers measured gene expression and monitored clinical responses in a cohort of MS patients treated with fingolimod, dimethyl fumarate, and teriflunomide over 12 months.
- Results showed increased inflammasome markers in fingolimod nonresponders after 3 and 6 months, while responders maintained baseline levels, indicating a potential link between NLRP3 activation and treatment efficacy in MS.
The application of convolutional neural networks (CNNs) to MRI data has emerged as a promising approach to achieving unprecedented levels of accuracy when predicting the course of neurological conditions, including multiple sclerosis, by means of extracting image features not detectable through conventional methods. Additionally, the study of CNN-derived attention maps, which indicate the most relevant anatomical features for CNN-based decisions, has the potential to uncover key disease mechanisms leading to disability accumulation. From a cohort of patients prospectively followed up after a first demyelinating attack, we selected those with T1-weighted and T2-FLAIR brain MRI sequences available for image analysis and a clinical assessment performed within the following six months (N = 319).
View Article and Find Full Text PDFImportance: Progression independent of relapse activity (PIRA) is the main event responsible for irreversible disability accumulation in relapsing multiple sclerosis (MS).
Objective: To investigate clinical and neuroimaging predictors of PIRA at the time of the first demyelinating attack and factors associated with long-term clinical outcomes of people who present with PIRA.
Design, Setting, And Participants: This cohort study, conducted from January 1, 1994, to July 31, 2021, included patients with a first demyelinating attack from multiple sclerosis; patients were recruited from 1 study center in Spain.
Serum Levels of CXCL13 Are Associated With Teriflunomide Response in Patients With Multiple Sclerosis.
Neurol Neuroimmunol Neuroinflamm
January 2023
Background And Objectives: To identify biomarkers associated with treatment response in patients with multiple sclerosis (MS) treated with the oral therapies teriflunomide, dimethyl fumarate (DMF), and fingolimod.
Methods: Serum levels of IL-6, IL-17, TNF-α, granulocyte-macrophage colony-stimulating factor, IL-10, interferon-gamma (IFN-γ) IL-1β, and chemokine ligand 13 (CXCL13) were measured at baseline and 12 months with single molecule array (Simoa) assays in a cohort of patients with MS treated with teriflunomide (N = 19), DMF (N = 22), and fingolimod (N = 25) and classified into "no evidence of disease activity" (NEDA) and EDA patients after 1 year of treatment.
Results: Serum CXCL13 and TNF-α levels were significantly decreased after treatment with teriflunomide in NEDA compared with EDA patients after 1 year of treatment ( = 0.
Article Synopsis
- Early identification of the transition from relapsing-remitting multiple sclerosis (RRMS) to secondary progressive MS (SPMS) is complex, mainly relying on assessing physical disability.
- A panel of 15 medical experts reached consensus on 72 out of 83 items regarding patient monitoring and the best clinical and paraclinical variables to detect early disease progression in MS, utilizing the RAND/UCLA Appropriateness Method.
- The established consensus can help neurologists better identify early SPMS progression, enabling them to plan more effective clinical and therapeutic interventions right from the beginning stages.
Background: Multiple sclerosis (MS) is an inflammatory and degenerative disease of the central nervous system with an increasing worldwide prevalence. Since 1993, more than 15 disease-modifying immunotherapies (DMTs) have been licenced and have shown moderate efficacy in clinical trials. Based on the heterogeneity of the disease and the partial effectiveness of therapies, a personalised medicine approach would be valuable taking individual prognosis and suitability of a chosen therapy into account to gain the best possible treatment effect.
View Article and Find Full Text PDFArticle Synopsis
- Intrathecal production of kappa free light chains, measurable by the kappa free light chain index, is significant in diagnosing multiple sclerosis and may be easier and more sensitive than traditional methods like oligoclonal bands and the IgG index.
- A study involving 214 patients assessed various diagnostic indices and found strong concordance between oligoclonal bands and different kappa free light chain cut-offs (specifically 5.9 and 6.6).
- The addition of kappa free light chain indexes to existing diagnostic criteria increased the number of confirmed multiple sclerosis cases, with the kappa free light chain-5.9 cut-off adding the most diagnoses.