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Gender effects on treatment response to interferon-beta in multiple sclerosis
M Magyari1, N Koch-Henriksen, B Laursen
1Danish Multiple Sclerosis Center, Department of Neurology, and the Danish Multiple Sclerosis Registry, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
Background:
Gender appears to play a role in incidence and disease course of multiple sclerosis (MS).
Objective:
The objective was to determine whether male and female patients with MS respond differently to interferon-beta treatment in terms of reduction in relapse rates.
Methods:
We included all 2033 patients with relapsing-remitting MS who started treatment with interferon-beta from 1996 to 2003, identified from the Danish Multiple Sclerosis Treatment Register. We defined neutralizing antibody (NAb)-positive and NAb-negative periods in the single patient by the results of the NAb tests. Patients served as their own controls, and relapse rates were compared between NAb-negative and NAb-positive periods.
Results:
NAbs significantly abrogated the interferon-beta treatment efficacy in both genders. The all-over women:men relapse rate ratio irrespective of NAb status was 1.47 (95%CI; 1.28-1.68). In a generalized linear Poisson models analysis with relapse counts as response variable, the main effects NAbs, sex, age at treatment start and number of relapses in 2 years before treatment start were strongly significant, but the effect of NAbs on relapse rates did not differ significantly between men and women.
Conclusion:
As NAbs influenced the on-treatment relapse rates strongly in both sexes but without statistical significant difference, there is no indication of different effects of interferon-beta in men or women.
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