Chronic systemic high-dose recombinant interferon alfa-2a reduces exacerbation rate, MRI signs of disease activity, and lymphocyte interferon gamma production in relapsing-remitting multiple sclerosis
ABSTRACT We report a randomized, double-blind, placebo-controlled pilot trial of systemic high-dose recombinant interferon alfa-2a (rIFNA) in 20 patients with relapsing-remitting (RR) multiple sclerosis (MS). Patients received 9 million IU rIFNA (n = 12) or placebo (n = 8) intramuscularly every other day for 6 months. Clinical exacerbations or new or enlarging lesions on serial MRI occurred in two of 12 rIFNA-treated and in seven of eight placebo-treated patients (p < 0.005). There was only one enlarging MRI lesion in the rIFNA group, whereas 27 new or enlarging lesions were present in the placebo group (p < 0.01). Baseline lymphocyte interferon gamma production of 19.10 +/- 7.12 IU/ml significantly decreased to 3.03 +/- 0.66 IU/ml (p < 0.04) in the rIFNA group, whereas production was unchanged in the placebo group. The rIFNA was tolerated without dropouts or serious side effects, but fever, malaise, fatigue (interfering with daily activities in two patients), and leukopenia occurred frequently. Neuropsychological tests excluded neurotoxicity. High-dose systemic rIFNA might reduce clinical and MRI signs of disease activity in RR MS and should be investigated in larger trials.
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ABSTRACT: e review studies that have examined the relationship between magnetic reso- nance imaging findings and clinical disability, postmortem observations, and cog- nitive dysfunction in patients with multiple sclerosis. We also review the use of magnetic resonance imaging findings as an outcome measure in clinical trials assessing the efficacy of new therapeutic agents for the treatment of multiple sclerosis. More ad- vanced applications of magnetic resonance imaging and their use in multiple sclerosis is ad- dressed later in the article. Arch Intern Med. 1998;158:565-573Archives of Internal Medicine 158(6):565-573. · 13.25 Impact Factor
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ABSTRACT: Multiple sclerosis (MS) is one of the most common chronic neurological diseases in young adults in western countries. An important aspect of treatment of this disease is the use of interferons (IFNs). These are molecules with antiviral, immunomodulatory, antiproliferative and hormonal activities. IFNβ, a class I IFN, has been used extensively in the therapy of MS, particularly in its relapsing-remitting (RRMS) phase, the most frequent clinical form of the disease. Although the available evidence from published clinical trials is difficult to evaluate because of methodological differences, an unbiased review of the data reveals sufficient evidence to conclude that treatment with IFNβ in RRMS is both efficacious and safe, at least over the periods so far investigated (up to 4–6 years). While there is no reason to suspect that IFNβ should not continue to be efficacious and safe over the longer term, studies investigating these questions over longer periods and including greater numbers of patients are needed.CNS Drugs 18(15). DOI:10.2165/00023210-200418150-00002 · 4.38 Impact Factor
- Annals of Neurology 01/1995; 37(1):7-15. DOI:10.1002/ana.410370105 · 11.91 Impact Factor