title: Poor responses to interferon-beta treatment in patients with neuromyelitis optica and multiple sclerosis with long spinal cord lesions.
abstract: Interferon-beta (IFN-β) treatment may not be effective in neuromyelitis optica (NMO). Whether the poor response to IFN-β is related to long spinal cord lesions (LSCL) or the NMO disease entity itself is unclear. We evaluated the spinal cord involvement of patients with multiple sclerosis (MS) and NMO, as well as the response after receiving IFN-β. Forty-nine MS and 21 NMO patients treated with IFN-β for at least 2 years from 2002-2008 were enrolled in this study and the treatment response was analyzed 2 years post-treatment. In the study, spinal cord lesions were present in 57.1% (28/49) of the MS patients, of which 16.3% (8/49) presented spinal cord lesions longer than 3 vertebral segments (LSCL). Responses to IFN-β treatment were seen in 69.3% (34/49) of all the MS cases, of which the appropriate response rates were 76.1% (16/21) in MS patients without spinal cord lesions and 37.5% (3/8) in patients with LSCL. Only 14.2% (3/21) of NMO patients responded to IFN-β treatment. In conclusion, spinal cord lesion is common in MS patients in Taiwan. Both NMO and MS patients with LSCL had a poor response to IFN-β treatment. NMO patients had a worse response to IFN-β treatment than MS patients with LSCL, which shows that the crucial structural defect is something other than LSCL such as the elevated serum IL17 level in NMO compared to MS.
authors.affiliation: Department of Neurology, Cheng Hsin General Hospital, Taipei, Taiwan; Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; National Yang-Ming University, School of Medicine, Taipei, Taiwan.
authors.forename: Kai-Chen
authors.initials: KC
authors.lastname: Wang
authors.affiliation: Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; National Yang-Ming University, School of Medicine, Taipei, Taiwan.
authors.forename: Kuan-Hsiang
authors.initials: KH
authors.lastname: Lin
authors.affiliation: Faculty of Public health, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Tzu-Chi
authors.initials: TC
authors.lastname: Lee
authors.affiliation: National Yang-Ming University, School of Medicine, Taipei, Taiwan; Department of Neurology, I-Lan Hospital, I-Lan, Taiwan.
authors.forename: Chao-Lin
authors.initials: CL
authors.lastname: Lee
authors.affiliation: Section of Hyperbaric Oxygen Medicine, Cardinal Tien Hospital, Taipei, Taiwan.
authors.forename: Shao-Yuan
authors.initials: SY
authors.lastname: Chen
authors.affiliation: Department of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Shyi-Jou
authors.initials: SJ
authors.lastname: Chen
authors.affiliation: Department of Microbiology & Immunology, National Chayi University, Chayi, Taiwan.
authors.forename: Li-Te
authors.initials: LT
authors.lastname: Chin
authors.affiliation: Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; National Yang-Ming University, School of Medicine, Taipei, Taiwan.
authors.forename: Ching-Piao
authors.initials: CP
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D051401:Aquaporin 4 / Q000378:metabolism; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D057809:HEK293 Cells; D006801:Humans; D016899:Interferon-beta / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000188:drug therapy*; D009471:Neuromyelitis Optica / Q000150:complications* / Q000188:drug therapy*; D012008:Recurrence; D013116:Spinal Cord / Q000187:drug effects / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D051401:Aquaporin 4; D016899:Interferon-beta