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Neutralizing antibodies and fatigue as predictors of low response to interferon-beta treatment in patients with multiple sclerosis.

Manceau P, Latarche C, Pittion S, Edan G, de Sèze J, Massart C, Debouverie M - BMC Neurol (2014)

Bottom Line: Their presence can lead to a decrease in interferon-beta (IFNβ) efficacy.Of the 176 patients included: 22.3% were NAb positive, 54.5% presented non-response criteria to IFNβ, and 57.4% had a pathological MFIS score.This study demonstrates the impact of NAb on the non-clinical response to IFNβ.

View Article: PubMed Central - PubMed

ABSTRACT

Background: The clinical impact of neutralizing antibodies against interferon-beta (NAb) is controversial. Their presence can lead to a decrease in interferon-beta (IFNβ) efficacy. Fatigue reported in patients with multiple sclerosis (MS) may be associated with an unfavorable clinical course. We conducted a prospective multicentre study to assess the association between response to IFNβ, NAb and fatigue.

Methods: Patients with relapsing-remitting MS on IFNβ treatment were included. During the second year of treatment, the patients were analyzed for NAb status and non-response criteria to IFNβ (number of relapses ≥1 during the follow-up period, increase in the Expanded Disability Status Scale ≥0.5). The score on the Modified Fatigue Impact Scale (MFIS pathological if score ≥35) was noted for each patient.

Results: Of the 176 patients included: 22.3% were NAb positive, 54.5% presented non-response criteria to IFNβ, and 57.4% had a pathological MFIS score. Fatigue was increased in NAb + patients (p = 0.0014) and they were more likely to present non-response criteria to IFNβ (p = 0.041) than NAb- patients. Multivariate logistic regression analysis showed that the presence of NAb was related to fatigue (p = 0.0032) and denoted disease activity in these patients (p = 0.026).

Conclusions: This study demonstrates the impact of NAb on the non-clinical response to IFNβ. Fatigue assessment is an indicator of IFNβ responsiveness and a predictive biomarker of deterioration on patient's neurological status.

No MeSH data available.


Related in: MedlinePlus

Comparison between NAb- and NAb + groups on the different scales at the time of the follow-up consultation. a. Mean MADRS score at follow-up consultation between NAb- and NAb + groups. b. Mean MSTCQ score at follow-up consultation between NAb- and NAb + groups. c. Mean MFIS score at follow-up consultation between NAb- and NAb + groups. d. Number of fatigue and no fatigue in NAb- and NAb + groups. **p <0.01, ***p <0.001.
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Fig2: Comparison between NAb- and NAb + groups on the different scales at the time of the follow-up consultation. a. Mean MADRS score at follow-up consultation between NAb- and NAb + groups. b. Mean MSTCQ score at follow-up consultation between NAb- and NAb + groups. c. Mean MFIS score at follow-up consultation between NAb- and NAb + groups. d. Number of fatigue and no fatigue in NAb- and NAb + groups. **p <0.01, ***p <0.001.

Mentions: Bivariate analysis showed a trend for NAb + patients to have a higher MADRS score (4.8 +/− 0.7) than NAb- patients (3.6 +/− 0.4; p = 0.14; Student t-test) (Figure 2a). NAb + patients tend to be less affected than NAb- patients by the flu-like syndrome as assessed by items 13 to 16 of the MSTCQ (5.9 +/− 0.8 vs. 7.2 +/− 0.4; p = 0.086; Student t-test) (Figure 2b). In terms of fatigue on the MFIS score, there was a significant difference between the NAb- group (34.2 +/− 1.7) and the NAb + group (47.3 +/− 2.9; p = 0.0002; Student t-test) (Figure 2c). Also, the ratio No fatigue patients/Fatigue patients was significantly different between the NAb- group (67/69) and the NAb + group (8/31; p = 0.0014, Chi-square test) (Figure 2d).Figure 2


Neutralizing antibodies and fatigue as predictors of low response to interferon-beta treatment in patients with multiple sclerosis.

Manceau P, Latarche C, Pittion S, Edan G, de Sèze J, Massart C, Debouverie M - BMC Neurol (2014)

Comparison between NAb- and NAb + groups on the different scales at the time of the follow-up consultation. a. Mean MADRS score at follow-up consultation between NAb- and NAb + groups. b. Mean MSTCQ score at follow-up consultation between NAb- and NAb + groups. c. Mean MFIS score at follow-up consultation between NAb- and NAb + groups. d. Number of fatigue and no fatigue in NAb- and NAb + groups. **p <0.01, ***p <0.001.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4256902&req=5

Fig2: Comparison between NAb- and NAb + groups on the different scales at the time of the follow-up consultation. a. Mean MADRS score at follow-up consultation between NAb- and NAb + groups. b. Mean MSTCQ score at follow-up consultation between NAb- and NAb + groups. c. Mean MFIS score at follow-up consultation between NAb- and NAb + groups. d. Number of fatigue and no fatigue in NAb- and NAb + groups. **p <0.01, ***p <0.001.
Mentions: Bivariate analysis showed a trend for NAb + patients to have a higher MADRS score (4.8 +/− 0.7) than NAb- patients (3.6 +/− 0.4; p = 0.14; Student t-test) (Figure 2a). NAb + patients tend to be less affected than NAb- patients by the flu-like syndrome as assessed by items 13 to 16 of the MSTCQ (5.9 +/− 0.8 vs. 7.2 +/− 0.4; p = 0.086; Student t-test) (Figure 2b). In terms of fatigue on the MFIS score, there was a significant difference between the NAb- group (34.2 +/− 1.7) and the NAb + group (47.3 +/− 2.9; p = 0.0002; Student t-test) (Figure 2c). Also, the ratio No fatigue patients/Fatigue patients was significantly different between the NAb- group (67/69) and the NAb + group (8/31; p = 0.0014, Chi-square test) (Figure 2d).Figure 2

Bottom Line: Their presence can lead to a decrease in interferon-beta (IFNβ) efficacy.Of the 176 patients included: 22.3% were NAb positive, 54.5% presented non-response criteria to IFNβ, and 57.4% had a pathological MFIS score.This study demonstrates the impact of NAb on the non-clinical response to IFNβ.

View Article: PubMed Central - PubMed

ABSTRACT

Background: The clinical impact of neutralizing antibodies against interferon-beta (NAb) is controversial. Their presence can lead to a decrease in interferon-beta (IFNβ) efficacy. Fatigue reported in patients with multiple sclerosis (MS) may be associated with an unfavorable clinical course. We conducted a prospective multicentre study to assess the association between response to IFNβ, NAb and fatigue.

Methods: Patients with relapsing-remitting MS on IFNβ treatment were included. During the second year of treatment, the patients were analyzed for NAb status and non-response criteria to IFNβ (number of relapses ≥1 during the follow-up period, increase in the Expanded Disability Status Scale ≥0.5). The score on the Modified Fatigue Impact Scale (MFIS pathological if score ≥35) was noted for each patient.

Results: Of the 176 patients included: 22.3% were NAb positive, 54.5% presented non-response criteria to IFNβ, and 57.4% had a pathological MFIS score. Fatigue was increased in NAb + patients (p = 0.0014) and they were more likely to present non-response criteria to IFNβ (p = 0.041) than NAb- patients. Multivariate logistic regression analysis showed that the presence of NAb was related to fatigue (p = 0.0032) and denoted disease activity in these patients (p = 0.026).

Conclusions: This study demonstrates the impact of NAb on the non-clinical response to IFNβ. Fatigue assessment is an indicator of IFNβ responsiveness and a predictive biomarker of deterioration on patient's neurological status.

No MeSH data available.


Related in: MedlinePlus