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Published on: March 24, 2015
Response to interferon beta-1a treatment in African American multiple sclerosis patients
Bruce A C Cree1, Ahmad Al-Sabbagh, Randy Bennett
1Multiple Sclerosis Center, University of California, San Francisco, 94117, USA. bcree@itsa.ucsf.edu
Background:
African Americans (AAs) with multiple sclerosis (MS) seem to have a more severe disease course than white Americans (WAs). To our knowledge, it is not known to what extent treatment with interferon beta-1a will effect the MS disease course within the AA population.
Objective:
To compare the response to treatment with interferon beta-1a between AA and WA MS patients.
Design:
This is an exploratory post hoc analysis of the Evidence of Interferon Dose-Response: European North American Comparative Efficacy (EVIDENCE) study.
Setting:
The EVIDENCE study is a randomized controlled trial that compared the efficacy of once weekly, intramuscular, 30-microg interferon beta-1a treatment with thrice weekly, subcutaneous, 44-microg interferon beta-1a therapy in treatment-naïve MS subjects.
Participants:
Thirty-six AA subjects were compared with 616 WA subjects.
Main Outcome Measures:
The number of MS exacerbations, the proportion of exacerbation-free subjects, and the number of new MS lesions present on brain magnetic resonance imaging were compared between AA and WA subjects at 24 and 48 weeks after initiating treatment with interferon beta-1a.
Results:
The AA subjects experienced more exacerbations and were less likely to remain exacerbation free (statistical trends). The AA subjects developed more new MS lesions on T2-weighted brain magnetic resonance imaging at 48 weeks (P = .04).
Conclusions:
Despite the small sample size, AA subjects appeared less responsive to treatment than WA subjects on outcome measures, reaching significance only for T2-weighted lesion count at 48 weeks. However, it is difficult to base these differences solely on response to treatment given the potential differing in MS disease course in AA patients.
Insights
African Americans with multiple sclerosis (MS) showed trends toward more exacerbations and new lesions compared to White Americans when treated with interferon beta-1a. Further research is needed to confirm these findings in MS patients.
Area of Science:
- Neurology
- Immunology
Background:
- Multiple sclerosis (MS) appears more severe in African Americans (AAs) compared to White Americans (WAs).
- The impact of interferon beta-1a on MS disease course in AAs is not well understood.
Purpose of the Study:
- To compare the effectiveness of interferon beta-1a treatment in African American (AA) versus White American (WA) patients with multiple sclerosis (MS).
Main Methods:
- An exploratory post hoc analysis of the EVIDENCE randomized controlled trial.
- Compared 36 AA subjects with 616 WA subjects receiving interferon beta-1a.
- Assessed MS exacerbations, exacerbation-free status, and new brain MRI lesions at 24 and 48 weeks.
Main Results:
- AA subjects had more MS exacerbations and were less likely to be exacerbation-free (statistical trends).
- AA subjects developed significantly more new T2-weighted brain lesions at 48 weeks (P = .04).
Conclusions:
- AA MS patients showed trends of reduced response to interferon beta-1a compared to WA patients.
- The observed differences may be influenced by potentially different MS disease courses in AAs.
- Further investigation is warranted, despite the small AA sample size.
