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Heterogeneity in response to interferon beta in patients with multiple sclerosis: a 3-year monthly imaging study
Annie W Chiu1, Nancy Richert, Mary Ehrmantraut
1Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892-1400, USA.
Objectives:
To investigate the heterogeneity in magnetic resonance image (MRI) patterns of response to interferon beta across patients with multiple sclerosis or within an individual patient over time.
Design, Setting, And Patients:
Fifteen patients with relapsing-remitting multiple sclerosis underwent monthly MRIs and clinical examinations (6-month pretherapy phase and 36-month therapy phase) and bimonthly neutralizing antibody tests. On each MRI, the total number of contrast-enhancing lesions was noted. Therapy MRI responders were defined as those with a reduction of 60% or more in the total number of contrast-enhancing lesions during each semester of therapy.
Intervention:
Subcutaneous administration of interferon beta-1b, 250 microg, every other day for 3 years.
Main Outcome Measure:
Reduction in the number of contrast-enhancing lesions.
Results:
Eight patients (53.3%) were MRI responders and 7 (46.7%) were nonresponders. Of those 7, 3 (20.0%) had only an initial optimal reduction of the total number of contrast-enhancing lesions, 2 (13.3%) never reached an optimal response, and 2 (13.3%) had a delayed optimal response. No clear association between neutralizing antibody profile and MRI response was evident.
Conclusions:
Multiple MRI evaluations disclose that approximately only half of the patients treated with interferon beta achieve and maintain a full response to the drug over time, although an additional small number of individuals may still restore an optimal response to the drug after an initial failure.
Insights
Magnetic resonance imaging (MRI) reveals that only about half of multiple sclerosis patients respond fully to interferon beta therapy over time. Some non-responders may still achieve an optimal response later in treatment.
Area of Science:
- Neurology
- Immunology
- Radiology
Background:
- Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
- Interferon beta (IFN-β) is a common therapy for relapsing-remitting MS, aiming to reduce disease activity.
- Understanding treatment response heterogeneity is crucial for optimizing MS management.
Purpose of the Study:
- To investigate variability in magnetic resonance imaging (MRI) response patterns to interferon beta in multiple sclerosis patients.
- To assess treatment response over time within individual patients and across the patient cohort.
Main Methods:
- Fifteen relapsing-remitting MS patients underwent monthly MRIs and clinical assessments for 3 years.
- Therapy response was defined by a ≥60% reduction in contrast-enhancing lesions per semester.
- Interferon beta-1b was administered subcutaneously every other day.
Main Results:
- 53.3% of patients were classified as MRI responders.
- 46.7% were non-responders, with varied patterns including initial response only, no optimal response, or delayed optimal response.
- No significant association was found between neutralizing antibody levels and MRI response.
Conclusions:
- Approximately half of MS patients achieve and sustain a significant MRI response to interferon beta.
- A subset of patients may exhibit a delayed optimal response after initial suboptimal treatment.
- MRI monitoring is essential for evaluating the long-term efficacy and heterogeneity of interferon beta treatment in MS.
Related Concept Videos
01:27Imaging Studies IV: Magnetic Resonance Imaging
01:19Multiple Sclerosis l: Introduction