Monthly MRI activity and clinical disability were evaluated in two relapsing-remitting multiple sclerosis (RRMS) patient for 4 years during a cross-over treatment trial with IFNβ-Ib, and for a mean of 21 months after terminating treatment with IFNβ-Ib. Post-treatment MRI activity was compared to baseline activity in these patient. Although contrast enhancing lesions (CEL) and the bulk white matter lesion load (BWMLL) on T2-weighted images eventually returned to baseline values, there was a refractory period of 6-10 months after terminating treatment before baseline MRI activity was restored. Although the mechanism for a sustained effect of IFNβ- Ib is unclear at this time, these result have important implications for enrollment of such patients into new treatment protocols that rely on contrast enhancing lesion frequency as an outcome measure.
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