About Radiologically Isolated Syndrome

“Radiologically isolated syndrome” (RIS) is diagnosed when it is discovered that someone has brain MRI abnormalities similar in appearance and location to abnormalities seen in people with MS. People with RIS are typically otherwise healthy and without any symptoms common for MS. However, up to 50% of people with RIS do go on to develop MS within 10 years 1. Some risk factors for developing MS, like age, spinal fluid abnormalities, and location of suspicious lesions, have been identified. However, right now, there is no treatment for RIS. Individuals with RIS typically follow up regularly with a neurologist who keeps a close eye on them, looking for signs of MS.

Although treatments for MS are getting better all the time, it remains a lifelong disease where most patients develop disability over time. Treating the disease very early helps reduce this risk. This is why it is so important to diagnose and treat MS early.

People who are closely related to individuals with MS are at higher risk for RIS and MS. About 2-3% of people whose siblings have MS will get MS, compared to an estimated 0.1% in the general population, and an estimated 3-10% of people whose siblings have MS have abnormal brain MRIs themselves 2-4.

What is the CELLO study all about?

The CELLO study is testing whether giving a short course of immune suppressing medication to people with RIS might prevent MS symptoms from ever developing. To study this, we will give half of our study participants an immune suppressing medication called ocrelizumab, and the other half an inactive placebo. We will then compare their symptoms and their MRI scans over time. Participants will be followed in the CELLO study for about 4 years. There are usually 2-3 study visits required per year.

The medication we are studying, ocrelizumab, is an FDA approved medication for MS. Ocrelizumab works by killing a subset of immune cells, called B-cells, which then gradually come back over time. It is given via an IV infusion every 6 months, and it is considered a highly effective medication for treating MS. Ocrelizumab has not yet been tested as a treatment for radiologically isolated syndrome. More information about ocrelizumab can be found at www.ocrevus.com.

Participants in the CELLO study will contribute blood and oral swabs throughout the study. Some participants will contribute spinal fluid. Examining these specimens will help generate important information about how the immune system behaves in RIS. This understanding could provide the groundwork for developing more effective ways to diagnose and treat MS earlier in the future.

Learn why studying immune cells from spinal fluid is important

  1. Lebrun-Frenay C, Kantarci O, Siva A, et al. Radiologically Isolated Syndrome: 10-Year Risk Estimate of a Clinical Event. Ann Neurol 2020;88:407-417.
  2. O’Gorman C, Lin R, Stankovich J, Broadley SA. Modelling genetic susceptibility to multiple sclerosis with family data. Neuroepidemiology 2013;40:1-12.
  3. Tienari PJ, Salonen O, Wikstrom J, Valanne L, Palo J. Familial multiple sclerosis: MRI findings in clinically affected and unaffected siblings. J Neurol Neurosurg Psychiatry 1992;55:883-886.
  4. Gabelic T, Ramasamy DP, Weinstock-Guttman B, et al. Prevalence of radiologically isolated syndrome and white matter signal abnormalities in healthy relatives of patients with multiple sclerosis. AJNR Am J Neuroradiol 2014;35:106-112.

Get started

If you qualify for the study and are interested in participating, please find your nearest participating location and reach out to the local study team. They will review the study with you in much more detail, including possible risks and potential benefits.

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