What You Should Know:
– Cleveland Clinic-led research team has been awarded a $7.2M grant from the National Institutes of Health (NIH) to support a multi-center study to study CVS, an MRI-based biomarker identified in multiple sclerosis associated white matter lesion.
– The prospective study, referred to as CAVS-MS, will enroll 400 patients with typical or atypical presentations of MS at 11 participating centers in North America, with Cleveland Clinic serving as the coordinating center.
The National Institutes of Health (NIH) has awarded $7.2 million to a Cleveland Clinic-led research team to improve accuracy of multiple sclerosis (MS) diagnoses leveraging biomarkers. Funded through the National Institutes of Neurological Disorders and Stroke’s Clinical Validation of a Candidate Biomarker for Neurological Disease Program Announcement, the multi-center study will evaluate whether a new biomarker, known as the central vein sign (CVS), can serve as a reliable diagnostic marker for MS.
Why It Matters
The need for improved diagnostic methods in MS is widely recognized. Although MRI is a longstanding tool for detecting MS lesions, diagnostic inaccuracies persist. Up to 1 in 5 people diagnosed with MS are later found not to have the disease, “Up to 20% of MS diagnoses turn out to be inaccurate,” said the study’s co-principal investigator, Daniel Ontaneda, M.D., Ph.D., of Cleveland Clinic’s Mellen Center for Multiple Sclerosis. “Our new multicenter study aims to reduce that number by evaluating if this new biomarker can improve diagnostic accuracy and simplify clinical decision-making.”
CAVS-MS Study Details
The prospective study, referred to as CAVS-MS, will enroll 400 patients with typical or atypical presentations of MS at 11 participating centers in North America, with Cleveland Clinic serving as the coordinating center. The study is being conducted under the auspices of the North American Imaging in MS Cooperative and will be led by Dr. Ontaneda and Dr. Nancy Sicotte, at Cedars-Sinai in Los Angeles.
The CVS is an MRI-based biomarker identified in MS-associated white matter lesions. CVS criteria — scoring of a brain MRI based on the presence of the CVS — have been well validated as a sensitive and specific marker of MS in cross-sectional studies.
Currently, the diagnosis of MS is based on criteria that are uninformative for nearly half of MS patients with atypical presentations. Timeliness of diagnosis is also key, as a diagnostic delay is common in relapsing-remitting MS and can carry severe and lifelong consequences. The primary objective is to determine whether use of CVS criteria allows for an earlier accurate diagnosis of MS in patients who do not meet the McDonald criteria at baseline. The researchers will also begin exploratory studies of optimal methods for integrating CVS findings into MS diagnostic criteria, along with any resulting healthcare-related cost savings.
“These initial exploratory analyses will be important to how readily positive findings about the utility of CVS criteria can impact clinical practice,” says Dr. Ontaneda. “The ultimate goal is to have the CVS incorporated into the MS diagnostic criteria.”