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Rate of brain atrophy in relapsing MS decreases during treatment with IFNbeta-1a
M Hardmeier1, S Wagenpfeil, P Freitag
1MS MRI Evaluation Centre Basel, University Hospitals Basel, Switzerland.
Objective:
To determine the time course of brain atrophy during treatment with once-weekly IM interferon beta-1a (IFNbeta-1a).
Methods:
The MRI cohort (n = 386) of the European IFNbeta-1a dose comparison study in relapsing multiple sclerosis (MS) was analyzed. In addition to baseline and three annual scans, a frequent subgroup (n = 138) had two scans before treatment initiation and scans at months 4, 5, 6, 10, and 11. Brain parenchymal fraction (BPF), a normalized measure of whole-brain atrophy, and volume of Gd-enhancing lesions (T1Gd) and T2 hyperintense lesions (T2LL) were evaluated.
Results:
BPF decrease was -0.686% (first year), -0.377% (second year), and -0.378% (third year). Analysis of the frequent subgroup showed that 68% of the first-year BPF decrease occurred during the first 4 months of treatment. This change was paralleled by a drop in T1Gd and T2LL. In the frequent subgroup, an annualized atrophy rate was determined by a regression slope for the pretreatment period and from month 4 of treatment onward. Annualized pretreatment rate (-1.06%) was significantly higher than the under-treatment rate (-0.33%).
Conclusions:
In the first year of treatment with anti-inflammatory agents, atrophy measurements are possibly confounded by resolution of inflammatory edema or more remote effects of previous damage to the CNS. The atrophy rate reduction observed after treatment month 4 may reflect a beneficial but partial effect of interferon beta-1a and was sustained over the 3-year study period.
Insights
Treatment with interferon beta-1a (IFNbeta-1a) significantly reduced brain atrophy rates in multiple sclerosis (MS) patients after the initial four months. This beneficial effect was sustained over three years.
Area of Science:
- Neuroscience
- Radiology
- Immunology
Background:
- Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS).
- Brain atrophy is a key measure of disease progression in MS.
- Interferon beta-1a (IFNbeta-1a) is a disease-modifying therapy used in MS treatment.
Purpose of the Study:
- To investigate the temporal pattern of brain atrophy during treatment with once-weekly intramuscular interferon beta-1a (IFNbeta-1a) in relapsing MS patients.
- To quantify the rate of brain atrophy before and during IFNbeta-1a treatment.
Main Methods:
- Analysis of MRI data from 386 relapsing MS patients in a European study.
- Detailed volumetric analysis of brain parenchymal fraction (BPF) and lesion volumes (T1Gd, T2LL) in a subgroup of 138 patients with frequent scanning.
- Calculation of annualized atrophy rates using regression slopes for pre-treatment and post-treatment periods.
Main Results:
- A significant reduction in the rate of brain atrophy was observed after the first four months of IFNbeta-1a treatment.
- The annualized brain atrophy rate decreased from -1.06% pre-treatment to -0.33% during treatment.
- This reduction in atrophy was associated with a decrease in T1Gd and T2LL, suggesting resolution of inflammation.
Conclusions:
- Early treatment with IFNbeta-1a leads to a significant and sustained reduction in brain atrophy rate in MS patients.
- The observed reduction in atrophy after four months may indicate a beneficial, albeit partial, effect of IFNbeta-1a.
- Atrophy measurements in the first year of treatment may be influenced by the resolution of inflammatory edema.
