{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T03:35:55Z","timestamp":1786505755627,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T00:00:00Z","timestamp":1665446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009945","name":"Merck KGaA","doi-asserted-by":"publisher","award":["10.13039\/100009945)"],"award-info":[{"award-number":["10.13039\/100009945)"]}],"id":[{"id":"10.13039\/100009945","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Measures of atrophy in the whole brain can be used to reliably assess treatment effect in clinical trials of patients with multiple sclerosis (MS). Trials assessing the effect of treatment on grey matter (GM) and white matter (WM) atrophy are very informative, but hindered by technical limitations. This study aimed to measure GM and WM volume changes, using a robust longitudinal method, in patients with relapsing MS randomized to cladribine tablets 3.5\u00a0mg\/kg or placebo in the CLARITY study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed T1\u2010weighted magnetic resonance sequences using SIENA\u2010XL, from 0 to 6\u00a0months (cladribine, <jats:italic>n<\/jats:italic>\u00a0=\u00a0267; placebo, <jats:italic>n<\/jats:italic>\u00a0=\u00a0265) and 6 to 24\u2009months (cladribine, <jats:italic>n<\/jats:italic>\u00a0=\u00a0184; placebo, <jats:italic>n<\/jats:italic>\u00a0=\u00a0186). Mean percentage GM and WM volume changes (PGMVC and PWMVC) were compared using a mixed\u2010effect model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>More GM and WM volume loss was found in patients taking cladribine versus those taking placebo in the first 6\u00a0months of treatment (PGMVC: cladribine: \u22120.53 vs. placebo: \u22120.25 [<jats:italic>p<\/jats:italic>\u00a0=\u00a00.045]; PWMVC: cladribine: \u22120.49 vs. placebo: \u22120.34 [<jats:italic>p<\/jats:italic>\u00a0=\u00a00.137]), probably due to pseudoatrophy. However, over the period 6 to 24 months, GM volume loss was significantly lower in patients on cladribine than in those on placebo (PGMVC: cladribine: \u22120.90 vs. placebo: \u22121.27 [<jats:italic>p<\/jats:italic>\u00a0=\u00a00.026]). In this period, volume changes in WM were similar in the two treatment arms (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.52).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>After a short period of pseudoatrophy, treatment with cladribine 3.5 mg\/kg significantly reduced GM atrophy in comparison with placebo. This supports the relevance of GM damage in MS and may have important implications for physical and cognitive disability progression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15579","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T06:59:16Z","timestamp":1664348356000},"page":"179-186","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Reduction in grey matter atrophy in patients with relapsing multiple sclerosis following treatment with cladribine tablets"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9803-7914","authenticated-orcid":false,"given":"Rosa","family":"Cortese","sequence":"first","affiliation":[{"name":"Department of Medicine, Surgery and Neurosciences University of Siena  Siena 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