Antibodies Could Signal Need for Change in Multiple Sclerosis Therapy

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Antibodies Could Signal Need for Change in Multiple Sclerosis Therapy

http://www.medscape.com/viewarticle/462770

NEW YORK (Reuters Health) Oct 09 - Neutralizing antibodies against interferon beta, a first-line treatment for multiple sclerosis (MS), can reduce the clinical efficacy of the drug, new research shows. The presence of such antibodies in nonresponders suggests the need for a different therapy.

In a study reported in the October 11th issue of The Lancet, Dr. Per Soelberg Sorensen, from Copenhagen University Hospital, and colleagues measured neutralizing antibodies every 12 months for up to 5 years in 541 MS patients treated with interferon beta between 1996 and 1999.

Age, sex, disease duration and progression did not predict the presence of neutralizing antibodies, the investigators note.

Patients were significantly more likely to experience a disease relapse during periods in which neutralizing antibodies were detected than during antibody-negative periods (p < 0.03). Moreover, after 1 year of treatment, antibody-negative patients experienced their first relapse 244 days later than antibody-positive patients (p = 0.009).

Although neutralizing antibodies were associated with relapse, they were not associated with disease progression, the authors point out. "Long-term studies are needed to clarify the correlation between these antibodies and disease progression."

"We recommend that treatment decisions should still primarily be based on clinical outcome, but in patients with neutralizing antibodies a change in treatment would be reasonable if substantial clinical activity is noted," they add.

Lancet 2003;362:1184-1191.

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