title: IFNβ-1b may severely exacerbate Japanese optic-spinal MS in neuromyelitis optica spectrum.
abstract: BACKGROUND
  Interferon-β-1b (IFNβ-1b) has been used to prevent exacerbation of relapsing-remitting multiple sclerosis (RRMS) including optic-spinal multiple sclerosis (OSMS) in Japan. We encountered 2 patients with OSMS with unexpectedly severe exacerbation soon after the initiation of IFNβ-1b therapy. The experience urged us to retrospectively review the patients with RRMS who had been treated with IFNβ-1b to identify similar cases.
  
  
  METHODS
  At neurologic departments of 9 hospitals, the medical records of 56 patients with RRMS were reviewed to identify those who showed severe exacerbation soon after the initiation of IFNβ-1b therapy.
  
  
  RESULTS
  Of 56 patients with RRMS, we identified 7 who experienced severe exacerbation (exacerbation with increased scores of Expanded Disability Status Scale ≧7.0) within 90 days of the initiation of IFNβ-1b therapy. In all 7 patients, the exacerbations after the initiation of IFNβ-1b therapy were more severe than those experienced by the individual patients before the use of IFNβ-1b, and seemed to have occurred unexpectedly in a short time after the initiation of INFβ-1b therapy. A retrospective analysis revealed that all 7 patients had antibodies toward aquaporin 4, and the clinical features of all 7 patients after the exacerbation were consistent with those of neuromyelitis optica (NMO) spectrum.
  
  
  CONCLUSIONS
  Our study suggests that IFNβ-1b may trigger severe exacerbation in patients with the NMO spectrum. In INFβ-1b therapy, cases in NMO spectrum should be carefully excluded.
authors.affiliation: Department of Neurology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. jshimizu-tky@umin.ac.jp
authors.forename: J
authors.initials: J
authors.lastname: Shimizu
authors.forename: Y
authors.initials: Y
authors.lastname: Hatanaka
authors.forename: M
authors.initials: M
authors.lastname: Hasegawa
authors.forename: A
authors.initials: A
authors.lastname: Iwata
authors.forename: I
authors.initials: I
authors.lastname: Sugimoto
authors.forename: H
authors.initials: H
authors.lastname: Date
authors.forename: J
authors.initials: J
authors.lastname: Goto
authors.forename: T
authors.initials: T
authors.lastname: Shimizu
authors.forename: M
authors.initials: M
authors.lastname: Takatsu
authors.forename: Y
authors.initials: Y
authors.lastname: Sakurai
authors.forename: H
authors.initials: H
authors.lastname: Nakase
authors.forename: Y
authors.initials: Y
authors.lastname: Uesaka
authors.forename: H
authors.initials: H
authors.lastname: Hashida
authors.forename: K
authors.initials: K
authors.lastname: Hashimoto
authors.forename: T
authors.initials: T
authors.lastname: Komiya
authors.forename: S
authors.initials: S
authors.lastname: Tsuji
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects*; D000328:Adult; D051401:Aquaporin 4 / Q000276:immunology; D044466:Asian People / Q000208:ethnology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000009:adverse effects*; D007564:Japan / Q000208:ethnology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D009471:Neuromyelitis Optica / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D009900:Optic Nerve / Q000187:drug effects / Q000473:pathology; D012189:Retrospective Studies; D013116:Spinal Cord / Q000187:drug effects / Q000473:pathology
chemical_list: D000276:Adjuvants, Immunologic; D051401:Aquaporin 4; D000068576:Interferon beta-1b; D016899:Interferon-beta