Vitamin D and disease activity in multiple sclerosis before and during interferon-β treatment.
OBJECTIVE
Studies based on deseasonalized vitamin D levels suggest that vitamin D may influence the disease activity in multiple sclerosis (MS), and high doses are suggested as add-on treatment to interferon-β (IFN-β). Seasonal fluctuation of vitamin D varies between individuals, thus the relationship to disease activity should preferentially be studied by repeated and simultaneous vitamin D and MRI measurements from each patient.


METHODS
This was a cohort study comprising 88 patients with relapsing-remitting MS who were followed for 6 months with 7 MRI and 4 25-hydroxyvitamin D measurements before initiation of IFN-β, and for 18 months with 5 MRI and 5 25-hydroxyvitamin D measurements during IFN-β treatment.


RESULTS
Prior to IFN-β treatment, each 10 nmol/L increase in 25-hydroxyvitamin D was associated with 12.7% (p = 0.037) reduced odds for new T1 gadolinium-enhancing lesions, 11.7% (p = 0.044) for new T2 lesions, and 14.1% (p = 0.024) for combined unique activity. Patients with the most pronounced fluctuation in 25-hydroxyvitamin D displayed larger proportion of MRI scans with new T1 gadolinium-enhancing lesions (51% vs 23%, p = 0.004), combined unique activity (60% vs 32%, p = 0.003), and a trend for new T2 lesions (49% vs 28%, p = 0.052) at the lowest compared to the highest 25-hydroxyvitamin D level. No association between 25-hydroxyvitamin D and disease activity was detected after initiation of IFN-β. HLA-DRB1*15 status did not affect the results.


CONCLUSIONS
In untreated patients with MS, increasing levels of 25-hydroxyvitamin D are inversely associated with radiologic disease activity irrespective of their HLA-DRB1*15 status.
Department of Neurology, Innlandet Hospital Trust, Lillehammer, Norway.
Kristin I
KI
Løken-Amsrud
Trygve
T
Holmøy
Søren J
SJ
Bakke
Antonie Giaever
AG
Beiske
Kristian S
KS
Bjerve
Bård T
BT
Bjørnarå
Harald
H
Hovdal
Finn
F
Lilleås
Rune
R
Midgard
Tom
T
Pedersen
Jurate Saltyte
JS
Benth
Leiv
L
Sandvik
Oivind
O
Torkildsen
Stig
S
Wergeland
Kjell-Morten
KM
Myhr
D000328:Adult; D017668:Age of Onset; D015331:Cohort Studies; D005260:Female; D005838:Genotype; D059811:HLA-DRB1 Chains / Q000235:genetics; D006801:Humans; D016899:Interferon-beta / Q000009:adverse effects* / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D009460:Neurologic Examination; D016017:Odds Ratio; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives / Q000378:metabolism*; D055815:Young Adult
D059811:HLA-DRB1 Chains; C507799:HLA-DRB1*15 antigen; D014807:Vitamin D; D016899:Interferon-beta; C104450:25-hydroxyvitamin D