Department of Neurology (MS Center Amsterdam), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
Nat Rev Neurol. 2011 Apr;7(4):221-8. doi: 10.1038/nrneurol.2011.22. Epub 2011 Mar 1.
Many patients with multiple sclerosis (MS) experience clinical relapses or progression of disability, or exhibit evidence of disease activity on MRI, despite the use of disease-modifying therapy. Although evidence clearly supports the efficacy of interferon β (IFN-β) in treating MS, the factors that determine the response to this drug in individual patients have not been fully elucidated. As more treatment options become available, the early identification of factors that can affect or predict the efficacy of agents in individual patients is important, because such knowledge facilitates early switching of treatment. Despite years of research and numerous reports of promising therapy markers for MS, few markers have emerged as clinically useful. Several studies suggest, however, that development of MRI lesions within 6-24 months after the initiation of IFN-β treatment predicts an unfavorable response. In addition, persistently high titers of neutralizing antibodies diminish or abrogate the therapeutic effects of IFN-β, and help to identify patients who do not respond. This Review highlights advances in research on the response to IFN-β in patients with MS and aims to provide a practical approach for incorporating clinical data, biological markers and MRI measures of disease activity into their therapeutic management.
许多多发性硬化症 (MS) 患者尽管使用了疾病修正治疗，但仍会经历临床复发或残疾进展，或在 MRI 上显示出疾病活动的证据。尽管有证据清楚地表明干扰素 β (IFN-β) 在治疗 MS 方面的疗效，但尚未完全阐明决定该药物在个体患者中反应的因素。随着更多治疗选择的出现，早期确定可能影响或预测个体患者药物疗效的因素非常重要，因为这种知识有助于早期进行治疗转换。尽管经过多年的研究和大量有希望的 MS 治疗标志物报告，但很少有标志物被证明具有临床实用性。然而，多项研究表明，IFN-β 治疗开始后 6-24 个月内出现 MRI 病变预示着不良反应。此外，持续高滴度的中和抗体降低或消除了 IFN-β 的治疗效果，并有助于识别无反应的患者。这篇综述强调了对 MS 患者对 IFN-β 反应的研究进展，并旨在为将临床数据、生物标志物和 MRI 疾病活动测量纳入其治疗管理提供一种实用方法。
