Publications by authors named "P Altmann"
Objective: To investigate retinal layer thinning as a biomarker of disease-modifying treatment (DMT) effects in relapsing multiple sclerosis (RMS).
Methods: From an ongoing prospective observational study, we included patients with RMS, who (i) had an optical coherence tomography (OCT) scan within 6 to 12 months after DMT start (rebaseline) and ≥1 follow-up OCT ≥12 months after rebaseline and (ii) adhered to DMT during follow-up. Differences between DMT in thinning of peripapillary-retinal-nerve-fiber-layer (pRNFL) and macular ganglion cell-plus-inner plexiform-layer (GCIPL) were analyzed using mixed-effects linear regression.
Background And Purpose: The rapidly evolving landscape of effective treatment options in multiple sclerosis has led to a shift of treatment objectives towards a treat-to-target approach aiming to suppress disease activity below the level of detectability early during the disease. To enable treat-to-target, a thorough reappraisal of available outcome measures with respect to their ability in this regard is required.
Methods: To that end, we conducted a comprehensive systematic literature review of more than 1000 studies using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 methodology focusing on underlying evidence as well as utility and implementability in clinical practice.
Article Synopsis
- Fabry disease (FD) is a rare genetic disorder that affects multiple organs, particularly the heart, kidneys, and brain, and researchers are exploring neurofilament light chains (sNfL) as a potential biomarker for nerve damage in these patients.
- A study measured serum NfL levels in 50 FD patients compared to 30 healthy individuals, finding significantly higher sNfL levels in FD patients, especially in males and those with brain white matter lesions.
- The elevated sNfL levels correlated with clinical disease severity and renal function, suggesting that sNfL could be a valuable indicator of neuroaxonal injury and may reflect broader cerebrovascular damage in FD patients.
Background And Objectives: Isolated value of MRI metrics in relapsing multiple sclerosis (RMS) as a surrogate marker of response to disease-modifying treatment (DMT) and, thus, as decision criteria for DMT escalation in the absence of clinical signs of disease activity is still a matter of debate. The aim of this study was to investigate whether DMT escalation based on isolated MRI activity affects clinical outcome.
Methods: Combining data from 5 MS centers in Austria and Switzerland, we included patients with RMS aged at least 18 years who (1) had initiated first-line, low-to-moderate-efficacy DMT (interferon β, glatiramer acetate, teriflunomide, or dimethyl fumarate) continued for ≥12 months, (2) were clinically stable (no relapses or disability progression) on DMT for 12 months, (3) had MRI at baseline and after 12 months on DMT, and (4) had available clinical follow-up for ≥2 years after the second MRI.
Article Synopsis
- Using a rebaselining concept can help reduce measurement noise in retinal layer thinning in patients with relapsing multiple sclerosis (RMS) by recalibrating assessments after treatment begins.
- In a study involving 173 RMS patients, significant increases in retinal layer thinning were associated with relapses and worsening disability before treatment, but not with the type of disease-modifying treatment (DMT) used.
- The findings suggest that rebaselining enhances the ability to distinguish the effects of different DMTs on retinal layer thinning by minimizing the influence of prior disease activity.