Department of Neurology, Research Institute and Hospital of National Cancer Center, 323 Ilsan street, Ilsandong-gu, Goyang-si, Gyeonggi-do, Korea.
Mult Scler. 2012 Oct;18(10):1480-3. doi: 10.1177/1352458512439439. Epub 2012 Feb 21.
Recent case reports and series have shown that patients with neuromyelitis optica (NMO) experience clinical deterioration under interferon beta (IFN-β) treatment. The objective of the present study was to evaluate whether and to what extent IFN-β exacerbates NMO spectrum disorders (NMOSD).
We retrospectively reviewed the medical records of 40 patients with NMOSD who had been treated with IFN-β for more than 6 months and whose disease duration was more than 1 year at the initiation of IFN-β treatment. We evaluated their annualized relapse rates (ARR) and Expanded Disability Status Scale (EDSS) scores before and after IFN-β treatment.
In total, 95% of patients exhibited an ineffective or exacerbated response to IFN-β treatment and the mean ARR significantly increased after IFN-β treatment (p = 0.002). The increased ARR > 50% under IFN-β treatment was observed in 20 patients (50%). The mean EDSS score significantly increased following IFN-β treatment (p < 0.001).
In patients with NMOSD, IFN-β 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.
最近的病例报告和系列研究表明，视神经脊髓炎（NMO）患者在干扰素β（IFN-β）治疗下会出现临床恶化。本研究旨在评估 IFN-β 是否以及在何种程度上加重了 NMOSD 谱障碍（NMOSD）。
我们回顾性分析了 40 例接受 IFN-β 治疗超过 6 个月且在 IFN-β 治疗开始时病程超过 1 年的 NMOSD 患者的病历。我们评估了他们在 IFN-β 治疗前后的年复发率（ARR）和扩展残疾状况量表（EDSS）评分。
共有 95%的患者对 IFN-β 治疗无反应或加重，IFN-β 治疗后 ARR 明显增加（p = 0.002）。20 名患者（50%）在 IFN-β 治疗下 ARR 增加>50%。IFN-β 治疗后 EDSS 评分明显升高（p < 0.001）。
在 NMOSD 患者中，IFN-β 治疗不仅不能预防复发，甚至可能显著增加复发。因此，对于 NMO 风险较高的患者，需要更仔细地诊断 NMO 与多发性硬化症，并注意治疗决策。
