Sage Journals: Discover world-class research

Abstract

Observational study designed to explore the effect of demographical variables and number of relapses over the disability progression in the two first years of beta-interferon treatment for multiple sclerosis. One hundred and sixty two patients treated with beta-interferon for at least two years were included, 70.9% females, mean age 33.4 years, mean disease duration 75.1 months, mean EDSS 2.4, previous year relapse rate 1.3. Main end-point was defined as a sustained EDSS increase (1.5 if previous EDSS 0-2.0; 1.0 if previous EDSS 2.5-4.0; 0.5 if previous EDSS 4.5 or higher). 62.3% of patients presented one or more relapses and 32.7% patients reached sustained disability increase. The univariate and multivariate Cox regression analysis only showed statistical significance for the relapses in the two first years after the treatment (HR 1 relapse: 3.4, p = 0.05; HR ≥ 2 relapses: 4.3, p < 0.001). The Kaplan-Meier survival analysis showed a higher probability of EDSS progression for patients with one relapse (log rank 10.9, p = 0.02) and with ≥ 2 relapses (log rank 17.7, p < 0.001), with no differences between them (p = 0.38). In conclusion, patients with one or more relapses in the first two years of interferon treatment developed an earlier sustained progression of the disability.

Keywords

multiple sclerosis beta-interferon relapses disability progression

Get full access to this article

View all access options for this article.

References

1 Rudick RA Lee J Simon J Ransohoff RM Fisher E . Defining interferon beta response status in multiple sclerosis patients. Ann Neurol 2004; 56: 548 – 555 .

2 Polman CH O’Connor PW Havrdova E Hutchinson M Kappos L Miller DH . A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med 2006; 354: 899 – 910 .

3 Hartung HP Gonsette R Konig N Kwiecinski H Guseo A Morrissey SP . Mitoxantrone in progressive multiple sclerosis: a placebo-controlled, double-blind, randomised, multicentre trial. Lancet 2002; 360: 2018 – 2025 .

4 Río J Nos C Tintoré M Téllez N Galán I Pelayo R . Defining the response to interferon-beta in relapsing–remitting multiple sclerosis patients. Ann Neurol 2006; 59: 344 – 352 .

5 Confavreux C Vukusic M Moreau T Adeleine P . Relapses and progression of disability in multiple sclerosis. N Engl J Med 2000; 343: 1430 – 1438 .

6 The IFNB multiple sclerosis group. Interferon beta-1b is effective in relapsing–remitting multiple sclerosis. I: Clinical results of a multicenter, double-blind, randomized, placebo-controlled trial. Neurology 1993; 43: 655 – 661 .

7 Dubois BD Keenan E Porter BE Kapoor R Rudge P Thompson AJ . Interferon beta in multiple sclerosis: experience in a British specialist multiple sclerosis centre. J Neurol Neurosurg Psychiatry 2003; 74: 946 – 949 .

8 Liu C Blumhardt LD . Assessing relapses in treatment trials of relapsing and remitting multiple sclerosis: can we do better? Mult Scler 1999; 5: 22 – 28 .

9 Sorensen PS Ross C Clemmesen KM Bendtzen K Frederiksen JL Jensen K . Clinical importance of neutralising antibodies against interferon beta in patients with relapsing-remitting multiple sclerosis. Lancet 2003; 362: 1184 – 1191 .

10.

10 Sorensen PS Deisenhammer F Duda P Hohlfeld R Myhr KM Palace J . Guidelines on use of anti-IFN-beta antibody measurements in multiple sclerosis: report of an EFNS Task Force on IFN-beta antibodies in multiple sclerosis. Eur J Neurol 2005; 12: 817 - 827 .

11.

11 Confavreux C Vukusic S Adeleine P . Early clinical predictors and progression of irreversible disability in multiple sclerosis: an amnesic process. Brain 2003; 126: 770 – 782 .

12.

12 Rudick RA Lee JC Simon J Ransohoff RM Fisher E . Defining interferon beta response status in multiple sclerosis patients. Ann Neurol 2004; 56: 548 – 555 .

13.

13 Waubant E Vukusic S Gignoux L Durand-Dubief F Achiti I Blanc S . Clinical characteristics of responders to interferon therapy for relapsing MS. Neurology 2003; 61: 184 – 189 .

14.

14 O’Rourke K Walsh C Antonelli G Hutchinson M . Predicting beta-interferon failure in relapsing–remitting multiple sclerosis. Mult Scler 2007; 13: 336 – 342 .

Effect of relapses over early progression of disability in multiple sclerosis patients treated with beta-interferon

Abstract

Keywords

Get full access to this article

References