European Neurology 46:4:2001, 210-214.
C. Laskea, P. Oschmanna, J. Tofighia,
B.S. Kühnea, H. Diehlb, T. Bregenzerc, J. Krausa, N. Chatzimanolisa,
R. Bauera, H. Traupeb, M. Kapsa
Departments of Neurology and Neuroradiology,
Justus Liebig University, Giessen; Department of Medical Statistics, biodat-PAREXEL,
Berlin, Germany
Abstract
The objective of this study was to
investigate the effect of interferon (IFN) beta-1b on the serum levels
of soluble tumor necrosis factor receptor 1 (sTNF-R1) and sTNF-R2 in patients
with multiple sclerosis (MS) in correlation with clinical and magnetic
resonance image (MRI) activity.
Serum samples were obtained every
3 months from 24 patients treated with 8 × 106 U of IFN beta-1b every
other day (treatment group) and from 21 patients without any immunomodulatory
therapy (control group) over a 15-month observation period.
The cytokine receptor levels were
assessed by ELISA.
Cranial MRI was performed every 6
months to determine the burden of disease.
In the treatment group, the MRI responders
had significantly larger mean values for the area under the concentration-time
curve of sTNF-R1 (p = 0.04) and sTNF-R2 (p = 0.01) when compared to the
MRI nonresponders during the 15-month observation period.
With regard to an increase in sTNF-R1
and -2 of more than 20% during the first 3 months of treatment, we observed
a sensitivity of 33 and 58%, respectively, a specificity of 90 and 60%,
respectively, and a positive predictive value of 80 and 64%, respectively,
for MRI response during the 15-month observation period.
A decrease in sTNF-R1 and -2 of more
than 20% during the first 3 months of treatment had a sensitivity of 40
and 20%, respectively, a specificity of 100 and 100%, respectively, and
a positive predictive value of 100 and 100%, respectively, for further
MRI nonresponse (during the 15-month observation period).
The present data suggest that assessment
of sTNF-Rs may contribute to the identification of subgroups of patients
who are likely to respond better than others to treatment with IFN beta-1b.
This could help to establish a cost-effective
prescription pattern for this expensive treatment, which is of importance
for the future management of patients with MS.
Copyright © 2001 S. Karger AG,
Basel