Abstract
BackgroundMyxovirus resistance protein A (MxA) is a molecule induced after interferon-beta injection, mostly used to evaluate its bioactivity. There is little available data on clinical utility of baseline MxA mRNA status. The objective of the study is to investigate whether baseline MxA mRNA expression can predict relapse and disease progression in multiple sclerosis patients treated with interferon-beta.MethodsBaseline blood samples were obtained before the first interferon-beta dose was administered to evaluate MxA mRNA expression using real-time polymerase chain reaction (PCR). Demographic and clinical variables were prospectively recorded to define treatment responder and non responder groups.Results104 patients were included in the study. Baseline MxA mRNA expression was significantly lower in the group of patients who met the definition of responders (1.07 vs 1.95, Student t test, p<0.0001). A threshold of 1.096 was established using Receiver Operating Characteristic analysis to differentiate between responders and non-responders (sensitivity 73.9%, specificity 69.0%). Survival analysis using this threshold showed that time to next relapse (p<0.0001) and to EDSS progression (p = 0.01) were significantly higher in patients with lower MxA titers.ConclusionThe results suggest that baseline MxA mRNA levels may be useful for predicting whether multiple sclerosis patients will respond or not to interferon-beta treatment.
Highlights
Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system that mainly affects middleaged adults and is a common cause of disability
The objective of this study is to investigate whether Myxovirus resistance protein A (MxA) mRNA baseline expression has a role in predicting the occurrence of relapses or disease progression in MS patients treated with Interferon beta (IFN-b)
Responders and non-responders At the end of follow-up, 58 (55.8%) patients met the definition of responders and 46 (44.2%) patients were classified as nonresponders
Summary
Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system that mainly affects middleaged adults and is a common cause of disability. Interferon beta (IFN-b) was the first approved and is one of the most common immunomodulatory therapies used for this condition. A percentage of patients do not respond to treatment, and this fact could only be recognized after months or years of therapy. It would be of value being able to determine whether a patient will respond to each type of treatment so that the most appropriate therapy can be given before the disease relapses or progresses. There is little available data on clinical utility of baseline MxA mRNA status. The objective of the study is to investigate whether baseline MxA mRNA expression can predict relapse and disease progression in multiple sclerosis patients treated with interferon-beta
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