Response to interferon in multiple sclerosis is related to lipid-specific oligoclonal IgM bands.
The objective of this study was to investigate whether the presence of lipid-specific oligoclonal IgM bands (LS-OCMB) in cerebrospinal fluid (CSF) influences the response to treatment with beta-interferon in relapsing-remitting multiple sclerosis (RRMS) patients. We performed a collaborative prospective study including RRMS patients with brain MRI and LS-OCMB studies performed before starting interferon treatment. The primary endpoint was the risk of having a relapse after treatment initiation. Secondary endpoints included relapse rate, relapse-rate reduction, proportion of relapse-free patients and proportion of patients with sustained disability increase during follow-up. One-hundred and two patients were included. After a mean follow-up of 37.4 months, the risk of suffering a relapse was two-fold higher in patients with LS-OCMB (hazard ratio 2.0, 95% confidence interval 1.1-3.8). LS-OCMB+ patients showed lower reduction in relapse rate (51.8% versus 80.8%; p < 0.0001), higher relapse rate in the first year (0.8 versus 0.2; p = 0.001), lower proportion of relapse-free patients (25% versus 61.3%; p = 0.003), and higher proportion of patients with sustained 1.0 increase in the Expanded Disability Status Score (45% versus 12.9%; p = 0.0003). In conclusion, LS-OCMB can have an influence on the response to interferon treatment in RRMS patients. They could be used as a biological marker to predict high inflammatory activity after treatment.
Neurology Service, Hospital Universitari La Fe, Valencia, Spain. isabelbosca@hotmail.com
I
I
Bosca
L M
LM
Villar
F
F
Coret
M J
MJ
Magraner
M
M
Simó-Castelló
J C
JC
Alvarez-Cermeño
B
B
Casanova
D000328:Adult; D057134:Antibodies, Neutralizing / Q000097:blood; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000134:cerebrospinal fluid*; D007155:Immunologic Factors / Q000276:immunology / Q000627:therapeutic use*; D000068556:Interferon beta-1a; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000276:immunology / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008055:Lipids / Q000276:immunology*; D008279:Magnetic Resonance Imaging; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D043025:Oligoclonal Bands / Q000134:cerebrospinal fluid*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D057134:Antibodies, Neutralizing; D007075:Immunoglobulin M; D007155:Immunologic Factors; D008055:Lipids; D043025:Oligoclonal Bands; D000068576:Interferon beta-1b; D016899:Interferon-beta; D000068556:Interferon beta-1a