IFNβ-1b may severely exacerbate Japanese optic-spinal MS in neuromyelitis optica spectrum
IFNβ-1b may severely exacerbate Japanese optic-spinal MS in neuromyelitis optica spectrum
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DOI：
10.1212/wnl.0b013e3181f8832e
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发表时间：
2010-10-19
期刊：
影响因子：
9.9
通讯作者：
Tsuji, S.
中科院分区：
文献类型：
--
作者：
Shimizu, J.;Hatanaka, Y.;Tsuji, S.
背景：干扰素-β-1b(干扰素-β-1b)在日本已被用于预防复发-缓解型多发性硬化症(RRMS)的恶化，包括视神经多发性硬化症(OSMS)。在干扰素β-1b治疗开始后不久，我们遇到了2名OSM患者，他们的病情恶化得出乎意料。方法：在9家医院的神经科，对56例RRMS患者在接受干扰素治疗后的病历进行分析。结果：在56例RRMS患者中，有7例患者在接受干扰素治疗后90天内出现严重加重(病情加重，扩展残疾状态量表评分增加<7.0分)。在所有7例患者中，干扰素β-1b治疗后的病情恶化比个别患者在使用干扰素β-1b之前更严重，而且似乎是在干扰素β-1b治疗开始后的短时间内意外发生的。经回顾性分析，7例患者均有水通道蛋白4抗体阳性，发病后的临床特征与视神经脊髓炎(NMO)谱相一致。结论：我们的研究提示，干扰素β-1b可能在NMO谱的患者中引发严重的加重。在干扰素β-1b治疗中，应小心排除NMO谱的病例。神经病学2010；75：1423-1427
Background: Interferon-beta-1b (IFN beta-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 IFN beta-1b therapy. The experience urged us to retrospectively review the patients with RRMS who had been treated with IFN beta-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 IFN beta-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 IFN beta-1b therapy. In all 7 patients, the exacerbations after the initiation of IFN beta-1b therapy were more severe than those experienced by the individual patients before the use of IFN beta-1b, and seemed to have occurred unexpectedly in a short time after the initiation of INF beta-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 IFN beta-1b may trigger severe exacerbation in patients with the NMO spectrum. In INF beta-1b therapy, cases in NMO spectrum should be carefully excluded. Neurology 2010;75:1423-1427