Determinants of Gd-enhanced MRI response to IFN-β-1a treatment in relapsing-remitting multiple sclerosis

1998 ◽  
Vol 4 (5) ◽  
pp. 403-407 ◽  
Author(s):  
T Koudriavtseva ◽  
C Pozzilli ◽  
M Fiorelli ◽  
C Gasperini ◽  
F Bagnato ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Period ◽  
Early Response ◽  
High Dose ◽  
Late Response ◽  
Relapsing Remitting ◽  
Change In The Mean ◽  
Remitting Multiple Sclerosis ◽  
Pre Treatment ◽  
Relapsing Remitting Multiple Sclerosis

The decision to use interferon beta (IFN-b) as a treatment for relapsing-remitting multiple sclerosis (RRMS) is based on both clinical characteristics and course of the disease. To better identify the profile of responders, the relationships between baseline clinical/MRI characteristics and therapeutical response was analyzed in 49 patients with RRMS randomly assigned to receive subcutaneously 3 or 9 MIU of IFN-b-1a. The therapeutical response was evaluated as a per cent change in the mean number and volume of monthly Gd-enhancing lesions in both first (early response) and second (late response) 6-month period of treatment, compared to the 6-month pre-treatment period. A better early response was seen in patients with a lower number of relapses during the pre-treatment period, while the late response was favourably influenced by a lower baseline EDSS and the high dose. Our findings suggest that the effect of IFN-b-1a on disease MRI activity is dose-related and dependent on the relapse rate and the level of disability before treatment.

scholarly journals A standardised frankincense extract reduces disease activity in relapsing-remitting multiple sclerosis (the SABA phase IIa trial)

2017 ◽  
Vol 89 (4) ◽  
pp. 330-338 ◽  
Author(s):  
Klarissa Hanja Stürner ◽  
Jan-Patrick Stellmann ◽  
Jan Dörr ◽  
Friedemann Paul ◽  
Tim Friede ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Activity ◽  
Treatment Period ◽  
Gastrointestinal Symptoms ◽  
Study Drug ◽  
Open Label ◽  
Clinical Trial Registration ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

ObjectiveTo investigate whether oral administration of a standardised frankincense extract (SFE) is safe and reduces disease activity in patients with relapsing-remitting multiple sclerosis (RRMS).MethodsWe performed an investigator-initiated, bicentric phase IIa, open-label, baseline-to-treatment pilot study with an oral SFE in patients with RRMS (NCT01450124). After a 4-month baseline observation phase, patients were treated for 8 months with an option to extend treatment for up to 36 months. The primary outcome measures were the number and volume of contrast-enhancing lesions (CEL) measured in MRI during the 4-month treatment period compared with the 4-month baseline period. Eighty patients were screened at two centres, 38 patients were included in the trial, 28 completed the 8-month treatment period and 18 of these participated in the extension period.ResultsThe SFE significantly reduced the median number of monthly CELs from 1.00 (IQR 0.75–3.38) to 0.50 (IQR 0.00–1.13; difference −0.625, 95% CI −1.25 to −0.50; P<0.0001) at months 5–8. We observed significantly less brain atrophy as assessed by parenchymal brain volume change (P=0.0081). Adverse events were generally mild (57.7%) or moderate (38.6%) and comprised mainly gastrointestinal symptoms and minor infections. Mechanistic studies showed a significant increase in regulatory CD4+ T cell markers and a significant decrease in interleukin-17A-producing CD8+ T cells indicating a distinct mechanism of action of the study drug.InterpretationThe oral SFE was safe, tolerated well and exhibited beneficial effects on RRMS disease activity warranting further investigation in a controlled phase IIb or III trial.Clinical trial registrationNCT01450124; Results.

scholarly journals Oral High-Dose Atorvastatin Treatment in Relapsing-Remitting Multiple Sclerosis

PLoS ONE ◽  
2008 ◽  
Vol 3 (4) ◽  
pp. e1928 ◽  
Author(s):  
Friedemann Paul ◽  
Sonia Waiczies ◽  
Jens Wuerfel ◽  
Judith Bellmann-Strobl ◽  
Jan Dörr ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
High Dose ◽  
Atorvastatin Treatment ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

scholarly journals Effects of immunomodulatory treatment with subcutaneous interferon beta-1a oncognitive decline in mildly disabled patients with relapsing—remitting multiple sclerosis

2009 ◽  
Vol 16 (1) ◽  
pp. 68-77 ◽  
Author(s):  
F. Patti ◽  
MP Amato ◽  
S. Bastianello ◽  
L. Caniatti ◽  
E. Di Monte ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Treatment Group ◽  
Interferon Beta ◽  
Neuropsychological Testing ◽  
High Dose ◽  
Relapsing Remitting ◽  
Disabled Patients ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

The objective of this study was to assess the effects of subcutaneous (sc) interferon beta-1a (IFNβ-1a) on cognition in mildly disabled patients with relapsing—remitting multiple sclerosis (RRMS). Patients aged 18—50 years with RRMS (McDonald criteria; Expanded Disability Status Scale score ≤4.0) were assigned IFNβ therapy at the physician’s discretion and underwent standardized magnetic resonance imaging, neurological examination and neuropsychological testing at the baseline and regular intervals for up to three years. This analysis included 459 patients who received sc IFNβ-1a (44 mcg: n = 236; 22 mcg: n = 223; three-year follow up was available for 318 patients). The hazard ratio for cognitive impairment over three years (44 mcg versus 22 mcg) was 0.68 (95% confidence interval [CI]: 0.480—0.972), suggesting a 32% lower risk with the higher dose treatment. At year 3, the proportion of patients who were cognitively impaired increased slightly from 23.5% at the baseline to 24.8% in the IFNβ-1a 22 mcg treatment group, but remained stable at 15.2% in the IFNβ-1a 44 mcg treatment group. The proportion of patients with cognitive impairment at year 3 was significantly higher in the 22 mcg group than in the 44 mcg group (P = 0.03), although a trend was also seen at the baseline (P = 0.058). Multivariate logistic regression (corrected for baseline cognitive deficits) indicated that treatment with the higher dose of IFNβ-1a was predictive of lower cognitive impairment at three years (odds ratio: 0.51, 95% CI: 0.26—0.99) compared with the lower dose of IFNβ-1a. These findings suggest that sc IFNβ-1a may have dose-dependent cognitive benefits in mildly disabled patients with RRMS, and may support early initiation of high-dose IFNβ-1a treatment.

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