Related Experiment Videos
The effect of IFNbeta-1b on the evolution of enhancing lesions in secondary progressive MS
P A Brex1, P D Molyneux, P Smiddy
1NMR Research Unit, Institute of Neurology, University College London, UK.
Background:
After the resolution of contrast enhancement, the majority of new MS lesions become isointense with surrounding white matter on T1-weighted MRI. Less commonly, a hypointense T1 lesion develops, representing the development of more severe focal tissue damage. Interferon beta (IFNbeta) reduces both the number of new enhancing lesions and the duration of contrast enhancement.
Objective:
To determine if IFNbeta affects the degree of tissue damage within new lesions and if its effects are related to lesion size.
Methods:
One hundred twenty-five patients with secondary progressive MS from seven European sites were randomized to receive either IFNbeta-1b or placebo. Monthly, contrast-enhanced T1-weighted MR images were acquired at baseline, at months 1 to 6, and at months 19 to 24. The size of all new enhancing lesions developing between months 1 and 6 was recorded and their appearance at follow-up documented.
Results:
In the first 6 months, fewer new enhancing lesions occurred in the IFNbeta-1b arm. This difference was greater for small (70% decrease) than for large (46% decrease) lesions. Hypointense T1 lesions were more likely to form from large (25%) than from small (9%) enhancing lesions in both treatment arms. Patients taking IFNbeta-1b developed fewer hypointense T1 lesions; however, the proportion of enhancing lesions developing into hypointense T1 lesions was similar in both arms.
Conclusion:
IFNbeta-1b reduced the number of new enhancing lesions, with a greater effect on small lesions. However, when a new enhancing lesion did become established, treatment with IFNbeta-1b did not alter its subsequent course.
Insights
Interferon beta-1b (IFNbeta-1b) reduces new multiple sclerosis (MS) lesions, especially smaller ones. However, IFNbeta-1b does not change the progression of established lesions in MS patients.
Area of Science:
- Neuroimaging
- Neurology
- Pharmacology
Background:
- Multiple sclerosis (MS) lesions typically become isointense on T1-weighted MRI post-enhancement.
- Hypointense T1 lesions indicate more severe tissue damage.
- Interferon beta (IFNbeta) is known to reduce new enhancing MS lesions and their enhancement duration.
Purpose of the Study:
- To investigate if IFNbeta affects tissue damage severity in new MS lesions.
- To determine if IFNbeta's effects on lesion damage are size-dependent.
Main Methods:
- 125 patients with secondary progressive MS were randomized to IFNbeta-1b or placebo.
- Monthly contrast-enhanced T1-weighted MRI scans were performed for 24 months.
- The size and follow-up appearance of new enhancing lesions (months 1-6) were documented.
Main Results:
- IFNbeta-1b significantly reduced the number of new enhancing lesions in the first 6 months.
- The reduction was more pronounced for small (70% decrease) versus large (46% decrease) lesions.
- Hypointense T1 lesions developed more frequently from large (25%) than small (9%) enhancing lesions, irrespective of treatment.
Conclusions:
- IFNbeta-1b effectively decreases the number of new enhancing MS lesions, particularly smaller ones.
- IFNbeta-1b treatment did not alter the subsequent development of hypointense T1 lesions once an enhancing lesion was established.