IFNβ-1b may severely exacerbate Japanese optic-spinal MS in neuromyelitis optica spectrum.
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.
Shimizu
J
J
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
Hatanaka
Y
Y
Hasegawa
M
M
Iwata
A
A
Sugimoto
I
I
Date
H
H
Goto
J
J
Shimizu
T
T
Takatsu
M
M
Sakurai
Y
Y
Nakase
H
H
Uesaka
Y
Y
Hashida
H
H
Hashimoto
K
K
Komiya
T
T
Tsuji
S
S
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
D000276:Adjuvants, Immunologic; D051401:Aquaporin 4; D000068576:Interferon beta-1b; D016899:Interferon-beta