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中和抗体的持久性取决于效价和干扰素-β制剂。

Persistency of neutralizing antibodies depends on titer and interferon-beta preparation.

机构信息

Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.

出版信息

Mult Scler. 2012 May;18(5):610-5. doi: 10.1177/1352458511426738. Epub 2011 Oct 19.

Abstract

BACKGROUND

Neutralizing antibodies (NAbs) affect the efficacy of interferon-beta (IFNβ) treatment in multiple sclerosis (MS) patients, particularly if NAbs persist. Persistency depends on NAb titers, which differ between IFNβ preparations.

OBJECTIVE

This study evaluated IFNβ preparation-specific NAb cut-off titers during early treatment for prediction of NAb persistency.

METHODS

Patients who had at least one NAb test between 12 and 30 months (baseline) as well as after more than 48 months (follow-up) on IFNβ treatment were included in this longitudinal study.

RESULTS

At baseline 1064 patients had a NAb test. Of those, 203 had a follow-up test. In the follow-up group 23.2% of patients were NAb positive during baseline. NAb frequency significantly decreased by 40.7% in the IFNβ-1a and by 60% in the IFNβ-1b group at follow-up after a mean time of 75.4 months on treatment, and median NAb titers decreased significantly in both groups. During baseline, NAb titers of >258 neutralizing units (NU) had a sensitivity of 81.3% and a specificity of 90.9% in the IFNβ-1a group, whereas titers of >460 NU had a sensitivity of 100% and a specificity of 91.7% in the IFNβ-1b group to predict persistency at follow-up. When these cut-off titers are applied, 10.2% of all treated patients developed persistent NAbs.

CONCLUSION

IFNβ preparation-specific NAb cut-off titers for prediction of NAb persistency, which may be useful in individual treatment decision making, are provided.

摘要

背景

中和抗体(NAb)会影响多发性硬化症(MS)患者干扰素-β(IFNβ)治疗的疗效,尤其是在 NAb 持续存在的情况下。NAb 的持续性取决于 NAb 滴度,不同 IFNβ 制剂之间的 NAb 滴度存在差异。

目的

本研究评估了早期治疗期间 IFNβ 制剂特异性 NAb 截断滴度,以预测 NAb 持续性。

方法

这项纵向研究纳入了至少在 IFNβ 治疗 12 至 30 个月(基线)以及超过 48 个月(随访)时进行了一次 NAb 检测的患者。

结果

在基线时,1064 例患者进行了 NAb 检测,其中 203 例患者进行了随访检测。在随访组中,基线时 23.2%的患者为 NAb 阳性。在 IFNβ-1a 组中,随访时 NAb 频率下降了 40.7%,在 IFNβ-1b 组中下降了 60%,中位 NAb 滴度在两组中均显著下降。在基线时,IFNβ-1a 组中 NAb 滴度>258 中和单位(NU)的敏感性为 81.3%,特异性为 90.9%,而 IFNβ-1b 组中 NAb 滴度>460 NU 的敏感性为 100%,特异性为 91.7%,可预测随访时的持续性。当应用这些截断滴度时,所有治疗患者中有 10.2%出现了持续性 NAb。

结论

本研究提供了 IFNβ 制剂特异性 NAb 截断滴度,用于预测 NAb 持续性,这可能有助于个体化治疗决策。

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