Characteristics of Radiologically isolated syndrome (RIS) national French Cohort
ECTRIMS Online Library. Lebrun-Frenay C. Oct 26, 2017; 199978; P323
Dr. Christine Lebrun-Frenay
Dr. Christine Lebrun-Frenay
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Abstract: P323

Type: Poster

Abstract Category: Clinical aspects of MS - 4 Natural course

Radiologically Isolated Syndrome (RIS) is characterized by patients with incidental findings on brain or spinal cord MRI which are suggestive of demyelinating disease without Multiple Sclerosis (MS) signs and symptoms.
The French RIS cohort is prospective and files are centralized and analyzed with a double-blind, standardized procedure. The aim is to confirm diagnosis, to collect clinical, biological and imaging data to promote researches.
This is a national prospective cohort, including 35 tertiary MS centers, gathering all RIS suspected cases since 2004. RIS files are identified in each center from the local MS Specialist. National coordinator collects all RIS cases and a double-blind MRI reading agrees for RIS status on imaging and patient medical history.
French Ris cohort contains 222 files in december 2016: 161 Women (72.5%), 61 Men (27.5%), Mean age 36.4 years [9.9 -71.4]. 32 files (14%) were classified as NON RIS and not included. On the 222 confirmed RIS cases, MRI motives are very variable: headache 27%, migraine 15%, vertigo 9%, trauma 5.9%, pain 4.5%, ophthalmic 2.5%, ENT 8.6%, depression 4.1%, witness study 0.5%, MS family 3.2%, somatoform 1.4%, fatigue 4.1%, other disease monitoring 13.1%, miscellaneous 9.5%. During the mean follow-up of 34 months [0-244], 30% of the patients have converted clinically. Mean time for the seminal event : 43 months after the first MRI [1.5 - 378.2], 25 % of patients with a primary progressive MS, 75% of patient with relapsing MS (spinal cord 29.9%, optic neuritis 14.9%, brainstem 4.5%, long tract 7.5%, other 17.9 %. Twenty-three patients (34%) had temporal MRI dissemination before clinical conversion.
To date 41 patients (26.5%) has DT on brain MRI but have not clinically converted.
The French prospective cohort has a standardized centralization with a yearly clinical, radiological and biological follow-up. The gathered prospective data does not seem to differ from those published in 2009 about a retrospective, smaller sample. It is important to improve the detection of patients and to better characterize some atypical neurological symptoms which could be considered as atypical forms of MS. To date, no treatment is available for RIS patients.
These data need to be included and confirmed in a prospective worldwide cohort effort. A European double blinded phase III study (TERIS) will start in 2017 which evaluate efficacy of teriflunomide vs placebo in delaying the clinical event.
Christine Lebrun Frenay is coordinator of TERIS study which is supported by Genzyme (Cambridge, MA, USA)
C Callier: nothing to disclose
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