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Published on: March 24, 2015
High-dose frequency beta-interferons increase the risk of liver test abnormalities in multiple sclerosis: a
1Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|December 15, 2010
Summary
High-frequency beta-interferon (IFNβ) treatments increase liver enzyme abnormalities in multiple sclerosis (MS) patients. Younger age, male gender, and early treatment duration also elevate risk, necessitating regular alanine aminotransferase (ALT) monitoring.
Area of Science:
- Neurology
- Hepatology
- Pharmacology
Background:
- Beta-interferon (IFNβ) therapy for multiple sclerosis (MS) is associated with liver enzyme abnormalities and injuries.
- Predictors for IFNβ-induced liver toxicity remain largely unknown.
- Identifying at-risk patients is crucial for safe MS management.
Purpose of the Study:
- To investigate the impact of IFNβ treatment and patient characteristics on alanine aminotransferase (ALT) levels in MS patients.
- To identify risk factors associated with de novo liver enzyme abnormalities during IFNβ therapy.
Main Methods:
- Retrospective review of ALT levels in 1064 MS patients receiving IFNβ as their initial immunomodulatory drug.
- Liver enzyme abnormality defined as ALT elevation ≥ 2 times the upper limit of normal (ULN).
- Generalized Estimating Equation (GEE) analysis to assess effects of age, gender, disease duration, IFNβ product, and treatment duration.
Main Results:
- 12.4% of MS patients developed de novo liver enzyme abnormalities over a mean treatment period of 38.7 months.
- Higher frequency IFNβ formulations (IFNβ-1a 44 µg SC, IFNβ-1b 250 µg SC) showed increased odds of liver enzyme abnormality compared to lower frequency IFNβ-1a 30 µg IM.
- Independent predictors of elevated ALT included younger age (≤40 years), male gender, and treatment duration ≤15 months.
Conclusions:
- A dose-frequency response relationship exists for IFNβ-induced liver enzyme elevations.
- The initial 15 months of treatment, male gender, and younger age are critical periods/factors for increased risk.
- Regular ALT monitoring is recommended for MS patients on IFNβ therapy; further research on long-term consequences of ALT elevations is warranted.
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