IFNβ-1b may severely exacerbate Japanese optic-spinal MS in neuromyelitis optica spectrum

Neurology. 2010 Oct 19;75(16):1423-7. doi: 10.1212/WNL.0b013e3181f8832e. Epub 2010 Sep 8.

Abstract

Background: Interferon-β-1b (IFNβ-1b) has been used to prevent exacerbation of relapsing-remitting multiple sclerosis (RRMS) including optic-spinal multiple sclerosis (OSMS) in Japan. We encountered 2 patients with OSMS with unexpectedly severe exacerbation soon after the initiation of IFNβ-1b therapy. The experience urged us to retrospectively review the patients with RRMS who had been treated with IFNβ-1b to identify similar cases.

Methods: At neurologic departments of 9 hospitals, the medical records of 56 patients with RRMS were reviewed to identify those who showed severe exacerbation soon after the initiation of IFNβ-1b therapy.

Results: Of 56 patients with RRMS, we identified 7 who experienced severe exacerbation (exacerbation with increased scores of Expanded Disability Status Scale ≧7.0) within 90 days of the initiation of IFNβ-1b therapy. In all 7 patients, the exacerbations after the initiation of IFNβ-1b therapy were more severe than those experienced by the individual patients before the use of IFNβ-1b, and seemed to have occurred unexpectedly in a short time after the initiation of INFβ-1b therapy. A retrospective analysis revealed that all 7 patients had antibodies toward aquaporin 4, and the clinical features of all 7 patients after the exacerbation were consistent with those of neuromyelitis optica (NMO) spectrum.

Conclusions: Our study suggests that IFNβ-1b may trigger severe exacerbation in patients with the NMO spectrum. In INFβ-1b therapy, cases in NMO spectrum should be carefully excluded.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adjuvants, Immunologic / adverse effects*
  • Adult
  • Aquaporin 4 / immunology
  • Asian Continental Ancestry Group / ethnology
  • Disability Evaluation
  • Female
  • Humans
  • Interferon beta-1b
  • Interferon-beta / adverse effects*
  • Japan / ethnology
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Neuromyelitis Optica / complications*
  • Neuromyelitis Optica / drug therapy*
  • Neuromyelitis Optica / immunology
  • Optic Nerve / drug effects
  • Optic Nerve / pathology
  • Retrospective Studies
  • Spinal Cord / drug effects
  • Spinal Cord / pathology

Substances

  • Adjuvants, Immunologic
  • Aquaporin 4
  • Interferon beta-1b
  • Interferon-beta