Beta interferons in clinically isolated syndromes: a meta-analysis

Melo, Aílton; Rodrigues, Bernardo; Bar‐Or, Amit

doi:10.1590/s0004-282x2008000100003

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…The 2-year cumulative risk of converting to McDonald-diagnosed MS was also significantly lower for patients receiving both doses of IFNB-1a in the REFLEX study compared with those receiving placebo (p e .0080 for both comparisons; Comi et al, 2012). A meta-analysis of data from two studies of IFNB-1a (CHAMPS and ETOMS) and one study of IFNB-1b (BENEFIT) for CIS supported the results of the individual studies; the risk of conversion from CIS to CDMS was reduced by 51% with IFNB treatment versus placebo, and treatment with IFNB delayed the conversion from CIS to CDMS from 317 days to 363 days (Melo, Rodrigues, & Bar-Or, 2008).…”

Section: Interferon-betamentioning

confidence: 78%

Impact of Delayed Diagnosis and Treatment in Clinically Isolated Syndrome and Multiple Sclerosis

Kennedy¹

2013

Journal of Neuroscience Nursing

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Multiple sclerosis (MS) is a progressive inflammatory disease with several possible clinical courses; before the development of definite MS, some patients may have clinically isolated syndrome (CIS), which is a single attack of neurological symptoms caused by inflammation or demyelination. Disease-modifying treatments (DMTs) have been extensively used for the management of MS, resulting in improvements in the clinical presentation and decreases in MS-associated neurological damage. Earlier initiation of DMT in the course of MS is associated with better outcomes. For patients with CIS, initiation of interferon-beta or glatiramer acetate treatment after an initial clinical event indicative of MS has been associated with delays in the progression to clinically definite MS as well as improvements in measures of neurological damage via magnetic resonance imaging. The initiation of treatment for patients with CIS should be considered, and nurses play a vital role in educating patients about the risks of conversion to MS and the benefits of early DMT.

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Section: Interferon-betamentioning

confidence: 78%

Impact of Delayed Diagnosis and Treatment in Clinically Isolated Syndrome and Multiple Sclerosis

Kennedy¹

2013

Journal of Neuroscience Nursing

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“…These studies represent evidence level 1 (recommendation grade A) and all showed that the administration of immunomodulating agents during CIS reduces the risk of a second demyelinating episode, without significant differences noted among the different types of immunomodulating agents [Clerico et al . 2008; Melo et al . 2008].…”

Section: Resultsmentioning

confidence: 99%

“…In all of them, the episode was treated with high methylprednisolone doses, and the trials evaluated the risk of subsequent conversion to clinically definite MS, that is, the occurrence of a second acute episode, which was the primary endpoint in all studies. These studies represent evidence level 1 (recommendation grade A) and all showed that the administration of immunomodulating agents during CIS reduces the risk of a second demyelinating episode, without significant differences noted among the different types of immunomodulating agents [Clerico et al 2008;Melo et al 2008]. The criteria for treating CIS with disease-modifying agents are based on the identification of those patients at high risk of developing MS.…”

Section: Treatmentmentioning

confidence: 99%

Optimizing outcomes in multiple sclerosis: consensus guidelines for the diagnosis and treatment of multiple sclerosis in Latin America

Carrá¹,

Macías-Islas²,

Gabbai³

et al. 2011

Ther Adv Neurol Disord

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Abstract:Objective: The prevalence of multiple sclerosis (MS) in Latin America varies across different studies but an intermediate risk and increased frequency of the disease have been reported in recent years. The circumstances of Latin American countries are different from those of Europe and North America, both in terms of differential diagnoses and disease management. Methods: An online survey on MS was sent to 855 neurologists in nine Latin American countries. A panel of nine experts in MS analyzed the results. Results: Diagnostic and therapeutic recommendations were outlined with special emphasis on the specific needs and circumstances of Latin America. The experts proposed guidelines for MS diagnosis, treatment, and follow up, highlighting the importance of considering endemic infectious diseases in the differential diagnoses of MS, the identification of patients at high risk of developing MS in order to maximize therapeutic opportunities, early treatment initiation, and cost-effective control of treatment efficacy, as well as global assessment of disability. Conclusions: The experts recommended that healthcare systems allocate a longer consultation time for patients with MS, which must be conducted by neurologists trained in the management of the disease. All drugs currently approved must be available in all Latin American countries and must be covered by healthcare plans. The expert panel supported the creation of a permanent forum to discuss future clinical and therapeutic recommendations that may be useful in Latin American countries.

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“…However, it is not universally effective, and it has been suggested that nearly half of MS patients are non-responsive to IFN-β [ 48 ]. It is most effective in the early stages of disease [ 49 ]; when applied upon the advent of a clinically isolated demyelinating event, evidence suggests that IFN-β can delay the onset of clinically defined MS [ 50 ]. However, it has modest efficacy in modulating the progressive phase of MS [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Interferon-β Suppresses Murine Th1 Cell Function in the Absence of Antigen-Presenting Cells

et al. 2015

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Interferon (IFN)-β is a front-line therapy for the treatment of the relapsing-remitting form of multiple sclerosis. However, its immunosuppressive mechanism of function remains incompletely understood. While it has been proposed that IFN-β suppresses the function of inflammatory myelin antigen-reactive T cells by promoting the release of immunomodulatory cytokines such as IL-27 from antigen-presenting cells (APCs), its direct effects on inflammatory CD4+ Th1 cells are less clear. Here, we establish that IFN-β inhibits mouse IFN-γ+ Th1 cell function in the absence of APCs. CD4+ T cells express the type I interferon receptor, and IFN-β can suppress Th1 cell proliferation under APC-free stimulation conditions. IFN-β-treated myelin antigen-specific Th1 cells are impaired in their ability to induce severe experimental autoimmune encephalomyelitis (EAE) upon transfer to lymphocyte-deficient Rag1-/- mice. Polarized Th1 cells downregulate IFN-γ and IL-2, and upregulate the negative regulatory receptor Tim-3, when treated with IFN-β in the absence of APCs. Further, IFN-β treatment of Th1 cells upregulates phosphorylation of Stat1, and downregulates phosphorylation of Stat4. Our data indicate that IFN-γ-producing Th1 cells are directly responsive to IFN-β and point to a novel mechanism of IFN-β-mediated T cell suppression that is independent of APC-derived signals.

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Beta interferons in clinically isolated syndromes: a meta-analysis

Cited by 6 publications

References 19 publications

Impact of Delayed Diagnosis and Treatment in Clinically Isolated Syndrome and Multiple Sclerosis

Impact of Delayed Diagnosis and Treatment in Clinically Isolated Syndrome and Multiple Sclerosis

Optimizing outcomes in multiple sclerosis: consensus guidelines for the diagnosis and treatment of multiple sclerosis in Latin America

Interferon-β Suppresses Murine Th1 Cell Function in the Absence of Antigen-Presenting Cells

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