http://www.ms-network.com/newsflash/show.asp?ID=215
19 June 2001
Li DK, Zhao GJ, Paty DW. Department
of Radiology (Dr. Li) and Division of Neurology (Drs. Zhao and Paty), Department
of Medicine, University of British Columbia, Vancouver, Canada.
OBJECTIVE:
To examine MRI changes resulting
from treatment of secondary progressive MS (SPMS) with two doses of interferon-beta-1a
(Rebif). BACKGROUND: Interferon-beta (IFN-beta) reduces relapses and delays
progression in relapsing-remitting MS, but there are conflicting results
on its clinical benefit in SPMS.
METHODS:
In a double-blind, randomized, multicenter,
placebo-controlled study (SPECTRIMS), 618 patients received IFN-beta-1a
22 &mgr;g, 44 &mgr;g, or placebo subcutaneously three times weekly
for 3 years. T2 activity and burden of disease (BOD) were measured in 617
patients by using semiannual proton density/T2-weighted (PD/T2) MRI scans.
A cohort of 283 patients also had 11 monthly PD/T2 and T1-weighted gadolinium-enhanced
(T1-Gd) scans at study start.
RESULTS:
Treatment reduced median numbers
of active lesions per patient per scan (semiannual T2 activity: 0.17, 0.20
and 0.67 for the high dose, low dose, and placebo, p < 0.0001; monthly
combined unique activity [T1+T2]: 0.11, 0.22, and 1.00, p < 0.0001)
and accumulation of BOD (percent change from baseline to month 36: -1.3,
-0.5, and 10.0 for the high dose, low dose, and placebo, respectively;
p = 0.0001). MRI benefit was most evident in the subgroup of patients who
reported relapses in the 2 years before the study. Neutralizing antibody
development was associated with reduction in treatment effect: antibody-positive
patients did not show significant differences from placebo at either dose.
CONCLUSIONS:
Interferon-beta-1a used in SPMS showed
significant effects on all MRI measures, particularly in patients with
relapses in the 2 years before the study.
Neurology 2001 Jun 12;56(11):1505-13