{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T10:46:38Z","timestamp":1791801998626,"version":"4.3.4"},"reference-count":38,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Chronic lesion tissue expansion (CLTE) reflects slow, concentric growth of established multiple sclerosis (MS) lesions and is linked to central brain atrophy and disability progression. Whether existing MS disease-modifying therapies (DMTs) differentially influence this aspect of progressive MS biology remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To compare the effect of current DMTs on CLTE in a multicentre, real-world MS cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a retrospective, observational study using linked clinical data from MSBase and the MSBase Imaging Repository. Data from patients aged\u2009\u2a7e18\u2009years with\u2009\u2a7e3 longitudinal MRI scans, and 7 therapies with\u2009\u2a7e100 stable treatment epochs were included. Therapy effects on CLTE, new T2 lesions, and brain atrophy were assessed using epoch-based covariate-adjusted generalised estimating equation models, with fingolimod as a comparator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result:<\/jats:title>\n                    <jats:p>\n                      The cohort included 564 patients contributing 1648 stable treatment epochs. After adjustment for demographic, clinical, and imaging covariates, B-cell depleting therapy was the only DMT associated with significantly lower CLTE (\u03b2\u2009=\u2009\u22124.03,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.017) relative to fingolimod. CLTE was independently associated with age, baseline lesion volume, and centre effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>B-cell depletion is associated with reduced CLTE, a promising biomarker of progressive MS biology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261459228","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:20:28Z","timestamp":1782919228000},"page":"1145-1154","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of multiple sclerosis disease-modifying therapies on chronic lesion tissue expansion"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0028-651X","authenticated-orcid":false,"given":"Daniel","family":"Guilfoyle","sequence":"first","affiliation":[{"name":"Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia; Royal Prince Alfred Hospital, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla","family":"Ward","sequence":"additional","affiliation":[{"name":"Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia; Royal Prince Alfred Hospital, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5761-5178","authenticated-orcid":false,"given":"Samuel","family":"Klistorner","sequence":"additional","affiliation":[{"name":"Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3213-8390","authenticated-orcid":false,"given":"Nathaniel","family":"Lizak","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neuroimmunology Centre, The Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of Medicine, CORe, The University of Melbourne, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi N","family":"Beadnall","sequence":"additional","affiliation":[{"name":"Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia; Royal Prince Alfred Hospital, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7799-1485","authenticated-orcid":false,"given":"Robert","family":"Zivadinov","sequence":"additional","affiliation":[{"name":"Department of Neurology, Buffalo Neuroimaging Analysis Centre, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6732-151X","authenticated-orcid":false,"given":"Bianca","family":"Weinstock-Guttman","sequence":"additional","affiliation":[{"name":"Jacobs MS Center for Treatment and Research, Buffalo, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izanne","family":"Roos","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neuroimmunology Centre, The Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of Medicine, CORe, The University of Melbourne, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3940-8727","authenticated-orcid":false,"given":"Helmut","family":"Butzkueven","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia; Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4278-7003","authenticated-orcid":false,"given":"Anneke","family":"van der Walt","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia; Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Buzzard","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Box Hill Hospital, Box Hill, VIC, Australia; Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Skibina","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Box Hill Hospital, Box Hill, VIC, Australia; Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike G","family":"Dwyer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Buffalo Neuroimaging Analysis Centre, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Barnett","sequence":"additional","affiliation":[{"name":"Department of Radiology, St Vincent\u2019s Hospital, Sydney, NSW, Australia; Sydney Neuroimaging Analysis Centre, Camperdown, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, The Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of Radiology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Department of Radiology, The Alfred Hospital, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Shieh","sequence":"additional","affiliation":[{"name":"Sydney Neuroimaging Analysis Centre, Camperdown, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Klistorner","sequence":"additional","affiliation":[{"name":"Save Sight Institute, The University of Sydney, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7135-7662","authenticated-orcid":false,"given":"Chenyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia; 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Alemtuzumab slowed brain atrophy over 6 years in patients without relapse and MRI disease activity: Post hoc analysis of the pooled CARE-MS studies. 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