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Tackling unmet MS-related cognitive challenges

Presented by
Dr Andrés Labiano-Fontcuberta, University Hospital "12 de Octubre", Spain
ECF 2020
Controlled studies comparing therapies with respect to their effects on rate of cognitive decline in multiple sclerosis (MS) are lacking. In addition, current open-label studies or clinical trials on cognitive functioning have not selected patients on criteria for cognitive dysfunction. So, the question remains if a cognitive-based early initiation of highly effective treatment should be considered.

Researchers from Spain initiated the CogEval project, comparing high efficacy versus usual first-line treatment in patients with cognitive dysfunction, evaluated via Processing Speed Test (PST) [1]. The PST is a self-administered iPad®-based tool to measure MS-related deficits in processing speed and its use has shown an advantage over pen-and-paper cognitive batteries because of its ease of administration and a standardised scoring system.

The aim of CogEval is to determine whether early initiation of highly effective disease-modifying therapy (DMT) in patients with relapsing-remitting MS is associated with a decreased rate of longitudinal cognitive decline. Dr Andrés Labiano-Fontcuberta (University Hospital "12 de Octubre", Spain) presented the methods and objectives of this randomised open-label pilot study. Patients who are not under consideration for initiation of high-efficacy DMT but whose results on PST are below normal limits will be enrolled. Participants will randomly be allocated into 2 groups:

  • experimental or intervention group, initiating highly-effective DMT (natalizumab, ocrelizumab, or alemtuzumab); and
  • control group without intervention, which will continue with the conventional first-line treatment.

After a treatment period of 24 weeks, change from baseline PST and proportion of cognitive decline-free patients will be assessed. Recruitment is still ongoing.

  1. Labiano-Fontcuberta A. CogEval project: tackling unmet multiple sclerosis-related cognitive challenges. ECF 28th Annual Meeting. Abstract 41.

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