title: Interferon-β therapy and risk of thrombocytopenia in multiple sclerosis patients.
abstract: Thrombocytopenia is a well-described adverse event of several disease-modifying therapies (DMT) in multiple sclerosis (MS). On the other hand, an increased prevalence of MS has been reported in patients with immune thrombocytopenia. In this retrospective, cross-sectional, case-control study we evaluated in a heterogeneous MS cohort: (1) the prevalence of thrombocytopenia in comparison with sex- and age-matched controls; (2) the relationship between thrombocytopenia and patients' demographic, clinical characteristics; (3) the risk for thrombocytopenia in relation to DMT. 187 consecutive MS patients [51 males, mean age (±SD) 44.5 ± 10.7 years] and 200 controls (56 males, mean age 45.5 ± 12 years) were included. Thrombocytopenia was defined as platelet count lower than normal laboratory values (130-400 × 10(9)/L). The prevalence of thrombocytopenia was significantly higher in MS patients than in controls (7 vs. 2.5 %, p = 0.04). Thrombocytopenia was present only in relapsing-remitting MS cases, and significantly associated with lower EDSS (p = 0.002) and with a trend for shorter disease duration (p = 0.06). It was more frequent in patients on high-dose interferon-β therapy compared with those on low-dose interferon-β therapy, other therapies or untreated patients (p = 0.02). High-dose interferon-β therapy was associated with more than eightfold increase in the risk for thrombocytopenia (odds ratio 8.60, 95 % confidence interval: 1.01-74.48 adjusted for EDSS, disease duration and type of disease). The prevalence of thrombocytopenia was increased in MS patients treated with DMT. High-dose interferon-β therapy is the variable most strongly associated with thrombocytopenia.
authors.affiliation: Multiple Sclerosis Center, Unit of Neurology, Regina Elena National Cancer Institute, IFO, Via Elio Chianesi 53, 00144, Rome, Italy. koudriavtseva@ifo.it.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Koudriavtseva
authors.affiliation: Multiple Sclerosis Center, Unit of Neurology, Regina Elena National Cancer Institute, IFO, Via Elio Chianesi 53, 00144, Rome, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Plantone
authors.affiliation: Multiple Sclerosis Center, Unit of Neurology, Regina Elena National Cancer Institute, IFO, Via Elio Chianesi 53, 00144, Rome, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Renna
authors.affiliation: Clinical Pathology, Regina Elena National Cancer Institute, IFO, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mandoj
authors.affiliation: Scientific Direction, Regina Elena National Cancer Institute, IFO, Rome, Italy.
authors.forename: Diana
authors.initials: D
authors.lastname: Giannarelli
authors.affiliation: Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Caterina
authors.initials: C
authors.lastname: Mainero
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D016899:Interferon-beta / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D012306:Risk; D013921:Thrombocytopenia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D016899:Interferon-beta
keywords: Beta-interferon; Disease-modifying therapies; Multiple sclerosis; Thrombocytopenia