Interferon beta-1b and intravenous methylprednisolone promote lesion recovery in multiple sclerosis.
OBJECTIVE
To determine whether lesion evolution in relapsing-remitting multiple sclerosis (RRMS) patients is altered by treatment with interferonbeta1b (IFNbeta-1b) or by intravenous methylprednisolone (IVMP) as measured by magnetization transfer imaging.


METHODS
Magnetization transfer ratios (MTR) of 225 contrast enhancing lesions (CEL), in four RRMS patients were serially determined for 12 months before and 12-18 months after contrast enhancement in a baseline vs treatment trial with IFNbeta-1b. During the baseline period, 185 new CEL were identified: 76 were treated with IVMP (1 g/day x 5 days) and designated steroid CEL (S-CEL); the remaining 109 were considered baseline lesions (BCEL). During IFNbeta-1b treatment, 40 CEL (IFN-CEL) were identified. After image co-registration, regions of interest (ROIs) defining new CEL were transferred to the MTR image set to determine the mean lesion MTR on each monthly exam. The lesion MTR was compared to MTR of normal appearing white matter (NAWM) on the same exam.


RESULTS
As early as 12 months prior to enhancement, the MTR of CEL was reduced compared to NAWM (mean 9.43 +/- 3.2%; P<0.001). The further reduction in MTR (28% +/- 4.0) at the time of contrast enhancement was not significantly different for BCEL, S-CEL or IFN-CEL Following enhancement, lesion recovery for IFN-CEL (P=0.02) and S-CEL (P=0.002) was significantly higher than BCEL CONCLUSION: IFNbeta-1b and IVMP reduce tissue damage and promote lesion recovery in RRMS patients. The additional benefit of IVMP compared to IFNbeta-1b may be related to its inhibitory effect on demyelination.
Richert
N D
ND
Laboratory of Diagnostic Radiology Research, Clinical Center, NIH, Bethesda, Maryland 20892, USA.
Ostuni
J L
JL
Bash
C N
CN
Leist
T P
TP
McFarland
H F
HF
Frank
J A
JA
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use*; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000473:pathology; D001812:Blood-Brain Barrier / Q000187:drug effects; D001921:Brain / Q000473:pathology; D003287:Contrast Media / Q000493:pharmacokinetics; D018592:Cross-Over Studies; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D019786:Gadolinium DTPA / Q000493:pharmacokinetics; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007275:Injections, Intravenous; D000068556:Interferon beta-1a; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000008:administration & dosage / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D003287:Contrast Media; D007166:Immunosuppressive Agents; D000068576:Interferon beta-1b; D016899:Interferon-beta; D019786:Gadolinium DTPA; D008775:Methylprednisolone; D000068556:Interferon beta-1a