Brain atrophy as a non-response predictor to interferon-beta in relapsing-remitting multiple sclerosis

作者：Ignacio Rojas Juan; Patrucco Liliana; Miguez Jimena; Besada Cristina; Cristiano Edgardo

来源：Neurological Research, 2014, 36(7): 615-618.

DOI：10.1179/1743132813Y.0000000304

• Multiple sclerosis
• Interferon
• Brain atrophy
• MR
• Response

Background: Several predictors for treatment failure to interferon-beta (IFN-beta) have been proposed; however, brain atrophy has not been well studied.
Methods: In this prospective and longitudinal study, all consecutive relapsing-remitting multiple sclerosis (RRMS) patients treated with sc IFN-beta-1a were included. Confirmed disability progression or a new relapse between weeks 48 and 144 after beginning with IFN-beta was considered as treatment non-response. EDSS progression, relapses, number of active lesions at 1 year (new or enlarging T2-weighted plus gadolinium-enhancing lesions, categorized in > 2 or <= 2), and brain parenchymal fraction (% BVC) volume change within the initial year of treatment were used as predictive factors. Cox regression model was adjusted for age, gender, and disease duration.
Results: Seventy-one patients were included (71.8% female) with a follow-up of 144 weeks. Thirty-four (48%) fulfilled criteria of non-response to IFN-beta treatment. The model showed: (1) relapses+disability progression: HR = 4.6, 95% IC: 3.1-6.7 (P < 0.001); (2) relapses+BVC decrease: HR = 4.1, 95% IC: 3.2-7.3 (P 5 0.001); (3) relapses+disability progression+new active lesions: HR 5 10.1, 95% IC: 7.1-15.2 (P, 0.001); and (4) relapses+disability progression+new active lesions+BVC decrease: HR = 14.4, 95% IC: 11.4-21.2 (P < 0.001).
Conclusions: Adding BVC measures to previously described predictive failure factors may increase sensitivity to early identify non-responder patients to IFN-beta-1a in the second and third years of therapy.

• 出版日期2014-7