219 MRI monitoring in MS patients prescribed disease monitoring treatments in Kings College Hospital

To date the MRI monitoring of MS patients on disease modifying treatments at KCH has gone unquanti- fied. This audit aimed to quantify and evaluate our current use of MRI in monitoring treatment response and safety in patients prescribed disease modifying treatments(DMTS) A list of patients prescribed DMTs between April 2016 and July 2019 was obtained via the Blueteq system. We used Cogstack to extract all MRI scan reports available for these patients (excluding pre-treatment scans). Every scan report was reviewed manually and the presence of new or enlarging T2 lesions and contrast enhancing lesions were documented for each of the different disease modifying treatments. 2072 scan reports were reviewed for 1250 patients prescribed DMTs. The largest number of monitoring scans were performed on patients prescribed Natalizumab (average 5.2 per scan per patient, compared to 1.04 scans per patient for alemtuzimab, 1.63 per patient for fingolimod). Patients prescribed higher efficacy drugs had the greatest proportion of stable MRI scans (93% + 85% of natalizumab and alem- tuzimab monitoring scans versus 66 and 70% of glatiramer acetate and B interferon monitoring scans, respectively). 3 of 2072 scans demonstrated imaging findings suspicious for PML (all patients prescribed natalizumab), 1 case was subsequently confirmed. r.raftopoulos@ucl.ac.uk