The effect of intramuscular interferon beta-1a on spinal cord volume in relapsing-remitting multiple sclerosis.

Sheena L Dupuy,Sonya Bakshi,Rohit Bakshi,Brian C Healy,Shahamat Tauhid,Fariha Khalid,Mohit Neema

doi:10.1186/s12880-016-0158-4

Sheena L Dupuy, Sonya Bakshi + Show 5 more

Open Access

https://doi.org/10.1186/s12880-016-0158-4

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Abstract

BackgroundSpinal cord atrophy occurs early in multiple sclerosis (MS) and impacts disability. The therapeutic effect of interferon beta-1a (IFNβ-1a) on spinal cord atrophy in patients with relapsing-remitting (RR) MS has not been explored.MethodsWe retrospectively identified 16 consecutive patients receiving weekly intramuscular IFNβ-1a for 2 years [baseline age (mean ± SD) 47.7 ± 7.5 years, Expanded Disability Status Scale score median (range) 1.5 (0–2.5), timed 25-foot walk 4.6 ± 0.7 seconds; time on treatment 68.3 ± 59.9 months] and 11 sex- and age-matched normal controls (NC). The spinal cord was imaged at baseline, 1 and 2 years later with 3T MRI. C1-C5 spinal cord volume was measured by an active surface method, from which normalized spinal cord area (SCA) was calculated.ResultsSCA showed no change in the MS or NC group over 2 years [mean annualized difference (95 % CI) MS: −0.604 mm2 (−1.352, 0.144), p = 0.106; NC: −0.360 mm2 (−1.576, 0.855), p = 0.524]. Between group analysis indicated no differences in on-study SCA change [MS vs. NC; year 1 vs. baseline, mean annualized difference (95 % CI) 0.400 mm2 (−3.350, 2.549), p = 0.780; year 2 vs. year 1: −1.196 mm2 (−0.875, 3.266), p = 0.245; year 2 vs. baseline −0.243 mm2 (−1.120, 1.607), p = 0.712].ConclusionEstablished IFNβ-1a therapy was not associated with ongoing spinal cord atrophy or any difference in the rate of spinal cord volume change in RRMS compared to NC over 2 years. These results may reflect a treatment effect. However, due to sample size and study design, these results should be considered preliminary and await confirmation.

Highlights

Spinal cord atrophy occurs early in multiple sclerosis (MS) and impacts disability
On-study spinal cord change: within group comparisons Considering the MS subgroup alone, no significant change was seen in spinal cord area (SCA) over the 2 year study period [mean annualized difference: −0.604 mm2 (−1.352, 0.144), p = 0.106]
When assessing the on-study change in SCA within the normal controls (NC) cohort, no significant difference was detected over 2 years [−0.360 mm2 (−1.576, 0.855), p = 0.524] (Table 3, Figs. 2 and 3)

Summary

Introduction

Spinal cord atrophy occurs early in multiple sclerosis (MS) and impacts disability. The therapeutic effect of interferon beta-1a (IFNβ-1a) on spinal cord atrophy in patients with relapsing-remitting (RR) MS has not been explored. Multiple sclerosis (MS) is a disease of the CNS characterized by lesions and atrophy in both the brain and spinal cord [1]. Studies have indicated the ability of weekly intramuscular IFNβ-1a to limit the rate of brain atrophy [23, 24]. No studies to date have examined spinal cord atrophy treatment effects in patients with relapsing forms of MS receiving weekly intramuscular IFNβ-1a. We performed a pilot study to assess the 2 year change in spinal cord volume associated with established IFNβ-1a treatment in comparison to healthy subjects

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