Serial MRI evaluations show that only half of patients with multiple sclerosis treated with interferon beta achieve and maintain a full response over time, according to findings published online November 10 from the January issue of the Archives of Neurology.
"Magnetic resonance imaging (MRI) allows for unique visibility of inflammatory plaques, namely contrast-enhancing lesions (CELs), in patients with multiple sclerosis (MS)," Dr. Francesca Bagnato and colleagues from the National Institutes of Health, Bethesda, Maryland, write. "Little is known regarding the heterogeneity of the MRI response profiles between patients or within an individual patient over time."
The researchers examined MRI response profiles among 15 patients with relapsing-remitting MS who underwent monthly MRIs and clinical examinations from a 6-month pretherapy phase followed by a 36-month therapy phase. They received subcutaneous administration of interferon beta-1b, 250 mcg, every other day during the treatment phase.
Overall, eight patients were classified as responders, and seven were non-responders. Of the seven non-responders, two had a delayed optimal response, three showed an initial optimal response but did not maintain the response over time, and two never reached an optimal response.
Neutralizing antibodies (NAbs) "appeared in five of the patients as early as the third month of therapy and decreased in titers during the third year of therapy," Dr. Bagnato and colleagues found.
"The occurrence of NAbs was generally low in MRI responders and more prominent in non-responders," they note. "However, no clear association between the NAb profile and MRI activity could be clearly identified within each NAb-positive patient."
The authors also acknowledge that the small number of patients precludes any definitive conclusion.
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