Does interferon beta treatment exacerbate neuromyelitis optica spectrum disorder?
Does interferon beta treatment exacerbate neuromyelitis optica spectrum disorder?
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DOI：
10.1177/1352458512439439
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发表时间：
2012-10-01
影响因子：
5.8
通讯作者：
Kim, Ho Jin
中科院分区：
文献类型：
--
作者：
Kim, Su-Hyun;Kim, Woojun;Kim, Ho Jin
目的：最近的病例报告和系列研究表明，视神经肌萎缩症（NMO）患者在干扰素β（IFN-β）治疗下出现临床恶化。本研究的目的是评估IFN-β是否以及在何种程度上加重了NMO谱系障碍（NMOSD）。方法：我们回顾性分析了40例NMOSD患者的病历，这些患者接受IFN-β治疗超过6个月，其疾病持续时间超过1年。我们评估了他们的年复发率（ARR）和扩展残疾状态量表（EDSS）评分之前和之后IFN-β treatment.Results：在总的，95%的患者表现出无效或恶化的反应IFN-β治疗和平均ARR显著增加IFN-β治疗后（p = 0.002）。在20名患者（50%）中观察到IFN-β治疗下ARR增加> 50%。IFN-β治疗后平均EDSS评分显著增加（p < 0.001）。结论：在NMOSD患者中，IFN-β治疗不仅不能有效预防复发，而且可能显著增加复发。因此，一个更仔细的诊断方法，以区分NMO多发性硬化症和注意治疗的决定是必要的患者在高风险的NMO。
Objectives: Recent case reports and series have shown that patients with neuromyelitis optica (NMO) experience clinical deterioration under interferon beta (IFN-beta) treatment. The objective of the present study was to evaluate whether and to what extent IFN-beta exacerbates NMO spectrum disorders (NMOSD).Methods: We retrospectively reviewed the medical records of 40 patients with NMOSD who had been treated with IFN-beta for more than 6 months and whose disease duration was more than 1 year at the initiation of IFN-beta treatment. We evaluated their annualized relapse rates (ARR) and Expanded Disability Status Scale (EDSS) scores before and after IFN-beta treatment.Results: In total, 95% of patients exhibited an ineffective or exacerbated response to IFN-beta treatment and the mean ARR significantly increased after IFN-beta treatment (p = 0.002). The increased ARR > 50% under IFN-beta treatment was observed in 20 patients (50%). The mean EDSS score significantly increased following IFN-beta treatment (p < 0.001).Conclusion: In patients with NMOSD, IFN-beta treatment is not only ineffective for preventing relapses but also may even increase relapses significantly. Thus, a more careful diagnostic approach to differentiate NMO from multiple sclerosis and attention to decision of treatment is warranted for patients at high risk of NMO.