Determinants of Gd-enhanced MRI response to IFN-β-1a treatment in relapsing-remitting multiple sclerosis

Abstract

The decision to use interferon beta (IFN-b) as a treatment for relapsing-remitting multiple sclerosis (RRMS) is based on both clinical characteristics and course of the disease. To better identify the profile of responders, the relationships between baseline clinical/MRI characteristics and therapeutical response was analyzed in 49 patients with RRMS randomly assigned to receive subcutaneously 3 or 9 MIU of IFN-b-1a. The therapeutical response was evaluated as a per cent change in the mean number and volume of monthly Gd-enhancing lesions in both first (early response) and second (late response) 6-month period of treatment, compared to the 6-month pre-treatment period. A better early response was seen in patients with a lower number of relapses during the pre-treatment period, while the late response was favourably influenced by a lower baseline EDSS and the high dose. Our findings suggest that the effect of IFN-b-1a on disease MRI activity is dose-related and dependent on the relapse rate and the level of disability before treatment.

Keywords

IFN-β-1a Gd-enhanced MRI therapeutical response relapsing-remitting multiple sclerosis

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References

The IFNB Multiple Sclerosis Study Group . (1993) Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. I. Clinical results of a multicenter, randomized, double-blind, placebo controlled trial . Neurology 43: 655-661 .

Paty DW , Li DK. (1993) Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. II. MRI analysis results of a multicenter, randomized, double-blind, placebo-controlled trial. UBC MS/MRI Study Group and the IFNB Multiple Sclerosis Group . Neurology 43: 662-667 .

The IFNB Multiple Sclerosis Study Group and the University of British Columbia MS/MRI Analysis Group . (1995) Interferon beta-1b in the treatment of multiple sclerosis: final outcome of the randomized controlled trial . Neurology 45: 1277-1285 .

Jacobs LD et al. (1996) Intramuscular interferon beta-1a for disease progression in relapsing multiple sclerosis . Ann Neurol 39: 285-294 .

Practice advisory on selection of patients with multiple sclerosis for treatment with Betaseron . (1994) Neurology 44: 1537-1540 .

Lublin FD et al. (1996) Management of patients receiving interferon beta-1b for multiple sclerosis: report of a consensus conference . Neurology 46: 12-18 .

Stone LA et al. (1995) The effect of Interferon-b on blood-brain barrier disruptions demonstrated by contrast-enhanced magnetic resonance imaging in relapsingremitting multiple sclerosis . Ann Neurol 37: 611-617 .

Pozzilli C et al. (1996) Magnetic resonance imaging changes with recombinant human interferon-b-1a: a short term study in relapsing-remitting multiple sclerosis . J Neurol Neurosurg Psychiatry 61: 251-258 .

Kurtzke JF. (1983) Rating neurologic impairment in multiple sclerosis: an Expanded Disability Status Scale (EDSS) . Neurology 33: 1444-1453 .

10.

Wicks D et al. (1992) Volume measurements of multiple sclerosis with magnetic resonance imaging . Neuroradiology 34: 475-479 .

11.

Weisnhenker BW. (1996) Clinical outcome measures for multiple sclerosis. In: Goodkin DE , Rudick RA , (eds). Advances in Clinical Trial Design, Treatment, and Future Perspectives. London: Springer , pp 105-122.

12.

McFarland HF et al. (1992) Using gadolinium-enhanced Magnetic Resonance Imaging lesions to monitor disease activity in multiple sclerosis . Ann Neurol 32: 758-766 .

13.

Miller DH et al. (1996) Guidelines for the use of Magnetic Resonance Techniques in Monitoring the Treatment of Multiple Sclerosis . Ann Neurol 39: 6-16 .

14.

Harris JO et al. (1991) Serial gadolinium-enhanced magnetic resonance imaging scans in patients with early, relapsing-remitting multiple sclerosis: implications for clinical trials and natural history . Ann Neurol 29: 548-555 .

15.

Karussis DM et al. (1996) Treatment of secondary progressive multiple sclerosis with the immunomodulator linomide: a double-blind, placebo-controlled pilot study with monthly magnetic resonance imaging evaluation . Neurology 47: 341-346 .

16.

Edan G et al. (1997) Therapeutical effect of mitoxantrone combined with methylprednisolone in multiple sclerosis: a randomised multicentre study of active disease using MRI and clinical criteria . J Neurol Neurosurg Psychiatry 62: 112-118 .

17.

Weinshenker BG , Issa M , Baskerville J. (1996) Long-term and short-term outcome of multiple sclerosis: a 3-year follow-up study . Arch Neurol 53: 353-358 .

18.

Duquette P , Houde-Sauve' M , Bedell L. (1997) Characteristics of relapsing-remitting multiple sclerosis patients as possible indicators of response to interferon beta-1b treatment . Neurology 48: A174-A174 .

19.

Perrillo RP et al. (1990) A randomized, controlled trial of Interferon Alpha-2a alone and after prednisone withdrawal for the treatment of chronic hepatitis B . N Engl J Med 323: 295-301 .

20.

Moormeier J et al. (1989) Low dose interferon in the treatment of hairy cell leukemia . J Natl Cancer Inst 81: 1172-1175 .

21.

Knobler RL et al. (1993) Systemic recombinant human interferon-b treatment of relapsing-remitting multiple sclerosis: pilot study analysis and six-year follow-up . J Interferon Res 13: 333-340 .