Elevated aminotransferases during treatment with interferon-beta for multiple sclerosis: actions and outcomes.
The authors report further analysis of a six-year retrospective chart review of multiple sclerosis (MS) patients prescribed interferon-beta (IFNB) in British Columbia, Canada. Actions and outcomes taken when 284/835 (34%) of the patients developed de novo elevated aminotransferases are presented; 239/284 (84%) of patients were continued on treatment despite these elevations; 216/246 (88%) of patients reaching grade 1 toxicity (greater than the upper limit of normal) continued IFNB treatment; of these, 167/216 (77%) returned to within normal limits. Of the 22/29 (76%) reaching grade 2 toxicity (> 2.5 times the upper limit of normal) and continuing treatment, 14/22 (64%) returned to within the normal range. One of the nine patients reaching grade 3 toxicity ( > 5 times the upper limit of normal) was allowed continue treatment and their aminotransferase levels returned to within normal limits. However, one patient reaching grade 3 toxicity went on to develop liver failure (previously reported).
Tremlett
Helen L
HL
University of British Columbia, Department of Medicine, Division of Neurology, Vancouver Hospital and Health Sciences Center, UBC Site, S159-2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5. tremlett@interchange.ubc.ca
Oger
Joel
J
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood / Q000209:etiology*; D005260:Female; D006801:Humans; D016899:Interferon-beta / Q000008:administration & dosage / Q000009:adverse effects*; D008099:Liver / Q000187:drug effects / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood / Q000188:drug therapy*; D012189:Retrospective Studies; D000637:Transaminases / Q000097:blood*
D000276:Adjuvants, Immunologic; D016899:Interferon-beta; D000637:Transaminases