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From the Departments of Radiology (Drs. Ge, Grossman, Udupa, and Fulton, and L.J. Mannon) and Neurology (Drs. Constantinescu, Gonzales–Scarano, and Kolson), Hospital of the University of Pennsylvania, Philadelphia, PA; the Mellen Center for MS Treatment and Research (Dr. Cohen), Cleveland Clinic Foundation, Cleveland, OH; and the Department of Biostatistics (Dr. Babb), Fox Chase Cancer Center, Philadelphia, PA.
Address correspondence and reprint requests to Dr. Robert I. Grossman, Department of Radiology, Hospital of the University of Pennsylvania, Founders, 3400 Spruce Street, Philadelphia, PA 19104-4283; e-mail: grossman{at}oasis.rad.upenn.edu
OBJECTIVE: To evaluate the efficacy of glatiramer acetate (GA, Copaxone; Teva Pharmaceutical Industries, Ltd., Petah Tiqva, Israel) by MRI-based measures in patients with relapsing–remitting (RR) MS.
METHODS: Twenty-seven patients with clinically definite RR-MS were treated with either 20 mg of GA by daily subcutaneous self-injection (n = 14) or placebo (n = 13) for approximately 24 months. Axial dual-echo fast-spin-echo T2-weighted images and T1-weighted images before and after gadolinium (Gd) were acquired at 1.5 tesla and transferred into an image processing computer system. The main outcome measures were the number of Gd-enhanced T1 and T2 lesions and their volume as well as brain parenchyma volume.
RESULTS: The values of age, disease duration, Expanded Disability Status Scale (EDSS) score, the number of T1- and T2-weighted lesions, and their volume were similar between GA- and placebo-receiving groups at the entry of this study. There was a decrease in the number of T1-enhanced lesions (p = 0.03) and a significant percent annual decrease of their volume in GA recipients compared with those of placebo recipients. There were no significant differences between changes in the two groups in the number of T2 lesions and their volume. The loss of brain tissue was significantly smaller in the GA group compared with that of the placebo group.
CONCLUSIONS: These results show that GA treatment may decrease both lesion inflammation and the rate of brain atrophy in RR-MS.
Key words: Glatiramer acetate—Relapsing-remitting MS—Expanded Disability Status Scale score—MR—Volume measurement
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