Abstract Details

Title Olfactory threshold as a biomarker predicting treatment response in relapsing multiple sclerosis

Topic Multiple Sclerosis

Presentation(s) P12 - Poster Session 12 (12:00 PM-1:00 PM)

Poster/Presentation
Number 9-005

Objective We aimed to investigate the potential of olfactory threshold for prediction of treatment response in relapsing multiple sclerosis (RMS).

Background Olfactory threshold impairment is transiently occurring in patients with active MS and during acute MS relapse resolving in phases of clinical stability and after initiation of disease-modifying treatment (DMT). Thus, threshold impairment is a marker of short-term inflammatory activity in MS.

Design/Methods In this 5-year prospective observational study on 113 RMS patients, olfactory threshold was measured at DMT initiation (M0) and after 3 (M3) and 12 months (M12) of follow-up by the Sniffin’ Sticks test. Inclusion criteria included adherence to DMT for at least 2 years. Treatment response was defined as absence of relapse during the observation period. Best possible cut-off values of olfactory threshold for predicting treatment response were determined by receiver-operating characteristics (ROC) analyses. Odds ratios (OR) for treatment response were calculated by stepwise multivariate logistic regression models correcting for age, sex and disease duration at baseline.

Results A combination of threshold score ≥6.0 at M3 and ≥1.0 points improvement from M0 to M3 sustained to M12 displayed the best prediction of treatment response (OR 5.1; 95% CI: 2.3 – 7.8; p<0.001; specificity 90%, sensitivity 83%) followed by threshold score ≥6.0 at M3 alone (OR 3.6; 95% CI: 1.3 – 7.0; p<0.001; specificity 83%, sensitivity 76%), ≥1.0 points improvement from M0 to M3 sustained to M12 alone (OR 3.5; 95% CI: 1.2 – 6.8; p<0.001; specificity 82%, sensitivity 70%).Threshold score at M12 alone and improvement from M3 to M12 was not significantly predictive. Also, adding threshold score at M12 to the model did not improve predictive accuracy.

Conclusions Olfactory threshold impairment predicts relapse activity upon DMT initiation. Pending validation, olfactory threshold may be a useful and easily obtainable biomarker of treatment response in RMS.

Authors/Disclosures
Gabriel Bsteh, MD (Medical University Vienna, Department of Neurology) PRESENTER	Dr. Bsteh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Bsteh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Bsteh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Bsteh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Bsteh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Bsteh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi.
Harald Hegen, MD	Dr. Hegen has nothing to disclose.
Klaus Berek, MD (Ao.BKH-Kufstein)	No disclosure on file
	No disclosure on file
	No disclosure on file
Michael Auer	Michael Auer has nothing to disclose.
Franziska Di Pauli	Franziska Di Pauli has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Franziska Di Pauli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Franziska Di Pauli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jannsen. Franziska Di Pauli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Franziska Di Pauli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Franziska Di Pauli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Franziska Di Pauli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Franziska Di Pauli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for horizon. Franziska Di Pauli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Franziska Di Pauli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for merck. Franziska Di Pauli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jannsen. Franziska Di Pauli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. The institution of Franziska Di Pauli has received research support from Roche.
Florian Deisenhammer, MD	Dr. Deisenhammer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Deisenhammer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Almirall. Dr. Deisenhammer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Deisenhammer has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS/Celgene. Dr. Deisenhammer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi/Genzyme. Dr. Deisenhammer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Deisenhammer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Deisenhammer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Deisenhammer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Almirall. Dr. Deisenhammer has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Deisenhammer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Celgene. Dr. Deisenhammer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genzyme. Dr. Deisenhammer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Dr. Deisenhammer has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Novartis. Dr. Deisenhammer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Deisenhammer has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for SOBI.
Thomas A. Berger, MD (Dept. of Neurology, Medical University of Vienna)	Prof. Berger has received personal compensation in the range of $10,000-$49,999 for serving as a speaker at scientific meetings and participant of local and international advisory boards with various companies producing and markerting treatments for multiple sclerosis (Almirall, Biogen, Biologix, Bionorica, Celgene-BMS, Merck, Novartis, Roche, Sanofi-Genzyme, TG Therapeutics, UCB).

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Abstract Details