Document Detail


Reduced effectiveness of long-term interferon-beta treatment on relapses in neutralizing antibody-positive multiple sclerosis patients: a Canadian multiple sclerosis clinic-based study.
MedLine Citation:
PMID:  17967840     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Multiple sclerosis (MS) patients treated with interferon-beta (IFN-beta) often form anti-IFN-beta antibodies accompanied by a reduction in IFN-beta bioavailability. The clinical effect of these antibodies remains controversial. MS patients in British Columbia, Canada, must be diagnosed and evaluated annually by neurologists in an MS clinic in order to be reimbursed for their IFN-beta prescriptions. We have identified at the UBC MS clinic a cohort of 262 patients, each having been treated with a single IFN-beta preparation more than three years, some for nearly a decade. Of 119 patients treated with Betaseron (IFN-beta1b), 18 (15.1%) were neutralizing antibody positive (NAb+) at the time of the study, whereas of 131 treated with subcutaneous Rebif (IFN-beta1a SC), 16 (12.2%) were NAb+, but none of 12 treated with intramuscular Avonex (IFN-beta1a) had detectable neutralizing antibodies. During the first two years of treatment, the relapse rate was significantly reduced from pre-treatment rates (P<0.001) and appeared to be unaffected by the subsequent NAb status. However, the relapse rates in the NAb+ patients were significantly greater than in the NAb- patients during years 3 (P<0.010) and 4 (P<0.027). Betaseron-treated NAb+ patients tended to have more relapses than NAb- patients during year 3 and this almost reached significance (P=0.056) but their relapse rate did not differ in year 4 and later. In contrast, Rebif-treated NAb+ patients tended to have more relapses in year 3 than Rebif-treated NAb- patients (P=0.074), but in year 4 they clearly (P=0.009) had more relapses than Rebif-treated NAb- patients. There was no convincing effect on progression of disability in any group.
Authors:
C Boz; J Oger; E Gibbs; S E Grossberg;
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Multiple sclerosis (Houndmills, Basingstoke, England)     Volume:  13     ISSN:  1352-4585     ISO Abbreviation:  Mult. Scler.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-30     Completed Date:  2008-02-21     Revised Date:  2008-08-21    
Medline Journal Info:
Nlm Unique ID:  9509185     Medline TA:  Mult Scler     Country:  England    
Other Details:
Languages:  eng     Pagination:  1127-37     Citation Subset:  IM    
Affiliation:
Department of Neurology, Medical Faculty of Karadeniz Technical University, Trabzon 61080, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adult
Autoantibodies / blood
British Columbia
Databases, Factual
Disability Evaluation
Disease Progression
Female
Humans
Immunologic Factors / therapeutic use*
Interferon-beta / therapeutic use*
Male
Middle Aged
Multiple Sclerosis, Relapsing-Remitting / drug therapy*,  immunology*
Outpatient Clinics, Hospital / statistics & numerical data
Retrospective Studies
Treatment Failure
Chemical
Reg. No./Substance:
0/Autoantibodies; 0/Immunologic Factors; 77238-31-4/Interferon-beta
Comments/Corrections
Comment In:
Mult Scler. 2007 Nov;13(9):1081-2   [PMID:  17967835 ]
Erratum In:
Mult Scler. 2008 May;14(4):575

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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