scholarly journals Response to Interferon-Beta Treatment in Afro-Caribbeans with Multiple Sclerosis

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
S. Jeannin ◽  
R. Deschamps ◽  
N. Chausson ◽  
P. Cabre
Keyword(s):  
Multiple Sclerosis ◽  
Relapse Rate ◽  
Interferon Beta ◽  
African Ancestry ◽  
Disease Course ◽  
Annual Relapse Rate ◽  
European Database ◽  
Treatment Naïve ◽  
First Relapse ◽  
The Impact

Background. Multiple sclerosis (MS) patients of African ancestry have a more aggressive disease course than white patients and could be resistant to interferon-beta (INFB).Methods. We studied the impact of INFB in treatment-naive Afro-Caribbean (AC) with clinically definite MS using our European Database for Multiple Sclerosis (EDMUS) (2003–2010). Main outcome measures were annual relapse rate after 2 years of treatment, proportion of exacerbation-free subjects 48 weeks after initiating INFB, and time to first relapse.Results. 76 AC-MS (59F/17M) were identified. Annual relapse rate of 1.29 decreased to 0.83 (−35.6%) after 2 years of treatment. The proportion of relapse-free patients at 48 weeks was 46.2%. Median time to first relapse was 52 weeks.Conclusion. INFB is not strong enough to control AC-MS patients in many cases which is problematic in a population of worse MS prognosis.

The Danish National Project of interferon-beta treatment in relapsing-remitting multiple sclerosis

2000 ◽  
Vol 6 (3) ◽  
pp. 172-175 ◽  
Author(s):  
Nils Koch-Henriksen ◽  
Per Soelberg Sùrensen ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Relapse Rate ◽  
Interferon Beta ◽  
Randomised Trial ◽  
Neutralizing Antibody ◽  
The European Union ◽  
Relapsing Remitting ◽  
First Relapse ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

After approval by the European Union in 1996 of interferon-beta for treatment of relapsing-remitting multiple sclerosis (RRMS), 862 patients in Denmark have received treatment (by April 1999), and 304 of those were enrolled into an open labelled randomised trial to compare the efficacy and tolerability of treatment with interferon-beta-1b (Betaferon) 8 MIU subcutaneous every other day and interferon-beta-1a (Rebif) 6 MIU subcutaneous once a week. Primary and secondary end-points included: (1) the relapse rate, (2) tolerability, (3) neutralizing antibody formation using the same specialised laboratory and validated assay, (4) time to first relapse, (5) time to sustained progression, and (6) number of gadolinium-enhancing lesions in T1-weighted MRI and the total lesion load in T2-weighted MRI. All the records are kept in a nationwide clinical database connected with the Danish Multiple Sclerosis Registry. The randomised trial will be completed by the end of 1999, and the results are not yet available. The annual relapse rate in all treated patients until April 1999 was 0.73, the annual rate of steroid treated relapses was 0.21. By 1 April 1999 8.8% of the patients had discontinued treatment and 10.4% had changed to another interferon-beta preparation. It has been planned to extend the follow-up of all patients treated according to the Danish National Protocol for a period of several years. The continuous and nation-wide registration of the course of the disease in interferon-beta treated RRMS patients may provide valuable knowledge of the treatment-modified long-term course of the disease in a cohort of patients, selected on the basis of well-defined criteria.

scholarly journals Clinical trials in relapsing-remitting multiple sclerosis (a new proposal for dealing with basic problems and restrictions)

2015 ◽  
Vol 84 (2) ◽  
pp. 104-106
Author(s):  
Mieczyslaw Wender ◽  
Grazyna Michalowska-Wender
Keyword(s):  
Multiple Sclerosis ◽  
Glatiramer Acetate ◽  
Relapse Rate ◽  
Interferon Beta ◽  
Therapy Group ◽  
Current Standard ◽  
Reference Drug ◽  
Disease Modifying Drugs ◽  
Double Blinded ◽  
Relapsing Remitting Multiple Sclerosis

The natural course of multiple sclerosis is characterized by a high variability of pattern, relapse rate and different progression indices. They also present a dramatic impact on the interpretation of treatment trials. Older reports, based on uncontrolled observations are therefore of little value. Currently it is generally accepted that a proper treatment trial should be double blinded and, although probably controversial, that it should be compared with a group of MS patients treated with placebo. Such an approach would be easily acceptable to prove the effectiveness of recently discovered disease modifying drugs. We know that current standard methods of therapy with interferon beta or glatiramer acetate are able to decrease the relapse rate at least by one third, to elongate the intervals between the relapses and to decrease the progression indices. Currently MS is considered a generalized degenerative disease. The lesions are persistent, therefore immunomodulatory treatment has to be started as early as possible. An alternative approach, somewhat suggestive for the use of placebo trials, seems to be a comparison of proposed new drug therapy group with a group of patients treated with a generally accepted reference drug, such as interferon beta or glatiramer acetate, including all clinical and MRI measures.

Smoking affects the interferon beta treatment response in multiple sclerosis

Neurology ◽  
2018 ◽  
Vol 90 (7) ◽  
pp. e593-e600 ◽  
Author(s):  
Eva R. Petersen ◽  
Annette B. Oturai ◽  
Nils Koch-Henriksen ◽  
Melinda Magyari ◽  
Per S. Sørensen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Relapse Rate ◽  
Interferon Beta ◽  
Human Leukocyte ◽  
Leukocyte Antigen ◽  
End Of Treatment ◽  
Relapsing Remitting ◽  
Observational Cohort ◽  
Treatment Register ◽  
Relapsing Remitting Multiple Sclerosis

ObjectiveTo investigate whether smoking in patients with relapsing-remitting multiple sclerosis (RRMS) treated with interferon beta (IFN-β) is associated with the relapse rate and whether there is an interaction between smoking and human leukocyte antigen (HLA)–DRB1*15:01, HLA-A*02:01, and the N-acetyltransferase-1 (NAT1) variant rs7388368A.MethodsDNA from 834 IFN-β–treated patients with RRMS from the Danish Multiple Sclerosis Biobank was extracted for genotyping. Information about relapses from 2 years before the start of treatment to either the end of treatment or the last follow-up visit was obtained from the Danish Multiple Sclerosis Treatment Register. Smoking information came from a comprehensive questionnaire.ResultsWe found that the relapse rate in patients with RRMS during IFN-β treatment was higher in smokers compared to nonsmokers, with an incidence rate ratio (IRR) of 1.20 (95% confidence interval [CI] 1.021–1.416, p = 0.027) and with an IRR increase of 27% per pack of cigarettes per day (IRR 1.27, 95% CI 1.056–1.537, p = 0.012). We found no association or interaction with HLA and the NAT1 variant.ConclusionIn this observational cohort study, we found that smoking is associated with increased relapse activity in patients with RRMS treated with IFN-β, but we found no association or interaction with HLA or the NAT1 variant.

Response to interferon-beta therapy in relapsing-remitting multiple sclerosis: a comparison of different clinical criteria

2006 ◽  
Vol 12 (3) ◽  
pp. 281-286 ◽  
Author(s):  
E Portaccio ◽  
V Zipoli ◽  
G Siracusa ◽  
S Sorbi ◽  
M P Amato
Keyword(s):  
Multiple Sclerosis ◽  
Relapse Rate ◽  
Interferon Beta ◽  
Clinical Criteria ◽  
Predictors Of Response ◽  
Lower Baseline ◽  
Disability Status ◽  
Relapsing Remitting ◽  
One Year ◽  
Relapsing Remitting Multiple Sclerosis

We assessed the proportion and potential predictors of response to interferon-beta (IFNβ) therapy in relapsing-remitting (RR) multiple sclerosis (MS) patients, comparing different definitions of response: a) lower relapse rate during therapy compared to the year and the two years before therapy, b) reduction of relapse rate during therapy of at least 30% compared to the two years before therapy, c) no relapse during treatment, d) no progression on the Expanded Disability Status Scale (EDSS). Among 147 RR patients treated for at least one year, 33 received IFNβ-1b subcutaneously (SC) (Betaferon), 59 IFNβ-1a intramuscularly (Avonex) and 55 IFNβ-1a SC (Rebif). Using definitions a), b) and d), 72%, 73% and 73% patients, respectively, were considered responders. Forty-four per cent of our patients were completely relapse free. In the logistic regression model, using definitions a) and b), a higher relapse rate in the two years preceding the therapy turned out to be a significant predictor of response. Considering definition c), lower baseline relapse rate was associated with a more favourable response.

Assessing Depression in Patients with Multiple Sclerosis

2004 ◽  
Vol 6 (3) ◽  
pp. 116-122 ◽  
Author(s):  
Zeeshan Butt ◽  
Heath A. Demaree
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Adherence ◽  
Future Research ◽  
Clinical Implications ◽  
Disease Course ◽  
Symptoms Of Depression ◽  
The Impact

Multiple sclerosis is frequently accompanied by symptoms of depression. Previous research has highlighted the impact of depression on MS disease course and treatment adherence. However, the assessment of depression in the context of MS is complicated by shared symptoms, such as fatigue and concentration difficulties. The goal of this paper is to describe the impact of depression in persons with MS and to review methods commonly used to assess depression in this population. Clinical implications of this review as well as recommendations for future research on the assessment of depression in MS will be discussed.

Interferon-beta affects mitochondrial activity in CD4+lymphocytes: Implications for mechanism of action in multiple sclerosis

2014 ◽  
Vol 21 (10) ◽  
pp. 1262-1270 ◽  
Author(s):  
Aiden Haghikia ◽  
Simon Faissner ◽  
Derek Pappas ◽  
Bartosz Pula ◽  
Denis A Akkad ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
T Cells ◽  
Energy Metabolism ◽  
Mitochondrial Function ◽  
Interferon Beta ◽  
Mononuclear Cells ◽  
Ex Vivo ◽  
Mitochondrial Activity ◽  
Mitochondrial Energy Metabolism ◽  
The Impact

Background:Whereas cellular immune function depends on energy supply and mitochondrial function, little is known on the impact of immunotherapies on cellular energy metabolism.Objective:The objective of this paper is to assess the effects of interferon-beta (IFN-β) on mitochondrial function of CD4+T cells.Methods:Intracellular adenosine triphosphate (iATP) in phytohemagglutinin (PHA)-stimulated CD4+cells of multiple sclerosis (MS) patients treated with IFN-β and controls were analyzed in a luciferase-based assay. Mitochondrial-transmembrane potential (ΔΨm) in IFN-β-treated peripheral blood mononuclear cells (PBMCs) was investigated by flow cytometry. Expression of genes involved in mitochondrial oxidative phosphorylation (OXPHOS) in CD4+cells of IFN-β-treated individuals and correlations between genetic variants in the key metabolism regulator PGC-1α and IFN-β response in MS were analyzed.Results:IFN-β-treated MS patients exhibited a dose-dependent reduction of iATP levels in CD4+T cells compared to controls ( p < 0.001). Mitochondrial effects were reflected by depolarization of ΔΨm. Expression data revealed changes in the transcription of OXPHOS-genes. iATP levels in IFN-β-responders were reduced compared to non-responders ( p < 0.05), and the major T allele of the SNP rs7665116 of PGC-1α correlated with iATP-levels.Conclusion:Reduced iATP-synthesis ex vivo and differential expression of OXPHOS-genes in CD4+T cells point to unknown IFN-β effects on mitochondrial energy metabolism, adding to potential pleiotropic mechanisms of action.

scholarly journals Disability and progression in Afro-descendant patients with multiple sclerosis

2016 ◽  
Vol 74 (10) ◽  
pp. 836-841 ◽  
Author(s):  
Juliana Calvet Kallenbach Aurenção ◽  
Claudia Cristina Ferreira Vasconcelos ◽  
Luiz Claudio Santos Thuler ◽  
Regina Maria Papais Alvarenga
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
African Ancestry ◽  
Clinical Aspects ◽  
Published Data ◽  
Therapeutic Decision ◽  
Disease Outcomes ◽  
The Impact ◽  
Clinical Characteristic

ABSTRACT Multiple sclerosis (MS) prevalence is higher in Caucasian (CA) populations, narrowing the analysis of the impact of Afro-descendant (AD) populations in disease outcomes. Even so, recent studies observed that AD patients have a more severe course. The main objective of this study is to confirm and discuss, through a systematic review, that being AD is a risk factor for disability accumulation and/or severe progression in patients with MS. A systematic review of published data in the last eleven years was performed, which evaluated clinical aspects and long term disability in patients with MS. Fourteen studies were included. Of these fourteen articles, thirteen observed a relationship between ancestry and poorer outcome of MS. African ancestry is a condition inherent in the patient and should be considered as an initial clinical characteristic affecting prognosis, and influencing which therapeutic decision to make in initial phases.

Influence of hypertension, diabetes, hyperlipidemia, and obstructive lung disease on multiple sclerosis disease course

2016 ◽  
Vol 23 (2) ◽  
pp. 277-285 ◽  
Author(s):  
Devon S Conway ◽  
Nicolas R Thompson ◽  
Jeffrey A Cohen
Keyword(s):  
Multiple Sclerosis ◽  
Lung Disease ◽  
Clinical Outcomes ◽  
Obstructive Lung Disease ◽  
Cumulative Effect ◽  
Disease Course ◽  
Logistic Regression Models ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Background: Comorbidities are known to affect multiple sclerosis (MS) patients in a number of ways, including delaying time to diagnosis and reducing health-related quality of life. Objective: To determine the impact of hypertension, hyperlipidemia, diabetes mellitus, and obstructive lung disease on disease course in MS patients. Methods: The Knowledge Program is a database linked to our electronic medical record allowing capture of patient and clinician reported outcomes. Through Knowledge Program query and chart review, we identified all relapsing-remitting MS patients seen between 1 January 2010 and 29 May 2012 and acquired their magnetic resonance imaging (MRI) results and comorbidities. Linear and logistic regression models with adjustment for important covariates were used to determine whether the comorbidities affected outcomes over a 3-year period. Results: Hypertension, diabetes, and obstructive lung disease, but not hyperlipidemia, impacted clinical outcomes, including walking speed, self-reported disability, and depression. Hypertension had the greatest effect. The presence of multiple comorbidities had a cumulative effect on clinical outcomes. MRI outcomes were unaffected by comorbidities. Conclusion: This 3-year longitudinal study revealed that all comorbidities tested except hyperlipidemia impacted clinical outcomes and a cumulative effect with multiple comorbidities was observed. Consideration of comorbid conditions is essential in MS patient care.

scholarly journals The Combined Effect of Nursing Support and Adverse Event Mitigation on Adherence to Interferon Beta-1b Therapy in Early Multiple Sclerosis

2012 ◽  
Vol 14 (4) ◽  
pp. 198-208 ◽  
Author(s):  
Suhayl Dhib-Jalbut ◽  
Clyde Markowitz ◽  
Payal Patel ◽  
Francis Boateng ◽  
Mark Rametta ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Adverse Event ◽  
Interferon Beta ◽  
Combined Effect ◽  
Adverse Event Rate ◽  
Dose Titration ◽  
Nursing Support ◽  
The Mean ◽  
The Impact ◽  
Mean Compliance

There is limited clinical evidence on the impact of nurse support and adverse event (AE) mitigation techniques on adherence to interferon beta-1b (IFNβ-1b) therapy in multiple sclerosis (MS) in a real-world setting. The aim of the Success of Titration, analgesics, and BETA nurse support on Acceptance Rates in MS Treatment (START) trial was to assess the combined effect of titration, analgesics, and BETA (Betaseron Education, Training, Assistance) nurse support on adherence to IFNβ-1b therapy in patients with early-onset MS and to evaluate safety. Participants were instructed to titrate IFNβ-1b and use analgesics to minimize flu-like symptoms. All received BETA nurse follow-up at frequent intervals: live training, two telephone calls during the first month of therapy, and monthly calls thereafter. Participants were considered adherent if they took at least 75% of the total prescribed doses over 12 months (≥75% compliance). Safety was monitored via reported AEs and laboratory test results. Participants who took at least one IFNβ-1b dose over 12 months were analyzed (N = 104); 73.8% of participants completed the study. The mean age of participants was 37.2 years; 72.1% were women and 78.8% were white. Ninety participants had relapsing-remitting MS and 14 had clinically isolated syndrome. The mean compliance rate, reported for 96 participants with complete dose interruption records, was 84.4%. At 12 months, 78.1% of participants were considered adherent. The serious adverse event rate was 9.6%; most events were unrelated to therapy. Thus in the START study, in which participants received nursing support combined with dose titration and use of analgesics, the majority of participants were adherent to therapy.

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