Fernández O, Antigüedad A, Arbizu T, Burgués S, Capdevila A, de Castro P, Correa de Sá J C, García-Merino J A, Izquierdo G, Magalhaes A, Montalbán X, Zarranz J J
Departamento de Neurología, Hospital Regional de Málaga, España.
Rev Neurol. 1999;29(12):1093-9.
The ability of natural human interferon beta (n-hIFN beta) to reduce multiple sclerosis (MS) activity was investigated in 60 patients with relapsing-remitting MS (RRMS).
Patients were randomized to receive either 9 MIU (33 micrograms) of n-hIFN beta by subcutaneous route, three times per week, on alternate days, during one year, or no treatment (control group) during the first six months and then switched to the same treatment for the following six months. Disease activity was monitored monthly by both magnetic resonance imaging (MRI) and clinical parameters. An intergroup analysis (first 6 months of the study) showed fewer active lesions and lower exacerbation rate in the treatment group than in the control group. Similarly, there were more exacerbation-free patients in the treatment group during this time.
When switched to treatment, the control group showed a significant reduction in the number of active lesions (p = 0.00001) and the exacerbation rate decreased by half. Exacerbation-free patients more than doubled (p = 0.006) and the median time to first exacerbation was significantly prolonged (96 vs > 180 days; p = 0.019). Treatment was extended for 12 additional months at a dose of 6 MIU (22 micrograms) once a week and disease activity persisted under control in 88% of patients. Treatment with n-hIFN beta was well tolerated, adverse events being mild and self-limiting. Sera were analyzed for anti-IFN beta antibodies and neutralizing activity was found in 12% of the patients after two years.
The results of this phase II study show, that n-hIFN beta promotes a significant reduction of disease activity in RRMS as shown by both MRI and clinical variables, and that the treatment is well tolerated, with low antigenicity.
在60例复发缓解型多发性硬化症(RRMS)患者中研究天然人干扰素β(n-hIFNβ)降低多发性硬化症(MS)活动的能力。
患者被随机分为两组,一组在一年中每周三次、隔天皮下注射9 MIU(33微克)n-hIFNβ,另一组在前六个月不接受治疗(对照组),然后在接下来的六个月改为相同治疗。通过磁共振成像(MRI)和临床参数每月监测疾病活动。组间分析(研究的前6个月)显示,治疗组的活动病灶较少,恶化率低于对照组。同样,在此期间治疗组中无恶化的患者更多。
转为治疗后,对照组的活动病灶数量显著减少(p = 0.00001),恶化率降低一半。无恶化患者增加了一倍多(p = 0.006),首次恶化的中位时间显著延长(96天对> 180天;p = 0.019)。以每周6 MIU(22微克)的剂量再延长治疗12个月,88%的患者疾病活动持续得到控制。n-hIFNβ治疗耐受性良好,不良事件轻微且为自限性。对血清进行抗IFNβ抗体分析,两年后12%的患者发现有中和活性。
这项II期研究的结果表明,n-hIFNβ可促进RRMS疾病活动显著降低,MRI和临床变量均显示如此,且该治疗耐受性良好,抗原性低。