Different responses to interferon beta‐1b treatment in patients with neuromyelitis optica and multiple sclerosis

Uzawa, Akiyuki; Mori, Masahiro; Hayakawa, Sohachiro; Masuda, Saeko; Kuwabara, Satoshi

doi:10.1111/j.1468-1331.2009.02897.x

Cited by 92 publications

(77 citation statements)

References 16 publications

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“…We did not observe differences in ARR between male and female patients; therefore, fre quency of attacks does not serve as explanation for dif ferences in duration between onset and diagnosis. Given the severity of attacks in NMO/SD and the dif ferences in treatment response between NMO/SD and MS, 20,21 an early correct diagnosis is essential. 22 Besides prevalence, clinical features in autoimmune diseases are known to be influenced by sex.…”

Section: Discussionmentioning

confidence: 99%

Influence of female sex and fertile age on neuromyelitis optica spectrum disorders

et al. 2016

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Background: Gender and age at onset are important epidemiological factors influencing prevalence, clinical presentation, and treatment response in autoimmune diseases. Objective: To evaluate the impact of female sex and fertile age on aquaporin-4-antibody (AQP4-ab) status, attack localization, and response to attack treatment in patients with neuromyelitis optica (NMO) and its spectrum disorders (neuromyelitis optica spectrum disorder (NMOSD)). Methods: Female-to-male ratios, diagnosis at last visit (NMO vs NMOSD), attack localization, attack treatment, and outcome were compared according to sex and age at disease or attack onset. Results: A total of 186 NMO/SD patients (82% female) were included. In AQP4-ab-positive patients, female predominance was most pronounced during fertile age (female-to-male ratio 23:1). Female patients were more likely to be positive for AQP4-abs (92% vs 55%; p < 0.001). Interval between onset and diagnosis of NMO/SD was longer in women than in men (mean 54 vs 27 months; p = 0.023). In women, attacks occurring ⩽40 years of age were more likely to show complete remission (p = 0.003) and better response to high-dose intravenous steroids (p = 0.005) compared to woman at >40 years. Conclusion: Our data suggest an influence of sex and age on susceptibility to AQP4-ab-positive NMO/ SD. Genetic and hormonal factors might contribute to pathophysiology of NMO/SD.

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Section: Discussionmentioning

confidence: 99%

Influence of female sex and fertile age on neuromyelitis optica spectrum disorders

et al. 2016

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“…Although only assessed by retrospective studies, the marked worsening of disability reported in some patients treated with interferon-β [19,20,[59][60][61][62], natalizumab [63][64][65], and fingolimod [66,67] should prompt us to avoid these therapies. Alemtuzumab, a T-and B-cell-depleting agent, was also shown to exacerbate NMOSD in single patients [51,68,69].…”

Section: Prevention Of Nmosd Attacks General Considerationsmentioning

confidence: 99%

Present and Future Therapies in Neuromyelitis Optica Spectrum Disorders

Kleiter

Gold

2016

Neurotherapeutics

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Neuromyelitis optica spectrum disorders (NMOSD) are important evolving entities, which have reached much attention in the recent years. NMOSD are characterized by inflammatory lesions in the optic nerves, spinal cord, and central parts of the brain, as well as an autoimmune process directed against aquaporin-4. As disability in NMOSD accumulates by inflammatory damage from attacks, both the treatment and prevention of attacks are decisive for the long-term outcome. NMOSD attacks are treated with highdose intravenous corticosteroids and apheresis therapies, in particular therapeutic plasma exchange. In cases of incomplete remission, escalation of attack treatment is recommended. Preventive therapy is immunosuppressive and should by commenced as early as possible. Apart from classical immunosuppressants such as azathioprine and mycophenolate mofetil, repurposed biologicals are increasingly used. B-cell depletion with rituximab and other agents, inhibition of the interleukin-6 receptor with tocilizumab, and blockade of complement-mediated damage by eculizumab all are promising therapeutic strategies evaluated in randomized controlled trials. In this review, we will discuss present and future immunotherapies for NMOSD and also consider combination of treatments, plasma, cellular and other therapies. Current advances in immunopathological knowledge are translated into innovative concepts and begin a new era of NMOSD therapy.

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“…However, interferon beta is not currently recommended for NMO patients and there are some evidences that it also may be even harmful, increasing the relapse rates 47 . Other Japanese studies reported MS patients with good response to interferon beta therapy, compared with NMO patients who experienced increased relapse rate after interferon beta treatment 48,49 . Similarly, a series of 25 NMO patients from France were reported to experience relapses following treatment with interferon beta 50 .…”

Section: Interferon Betamentioning

confidence: 99%

Treatment of neuromyelitis optica: an evidence based review

Sato

Callegaro

Lana-Peixoto

et al. 2012

Arq. Neuro-Psiquiatr.

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Neuromyelitis optica (NMO) is an inflammatory disease of the central nervous system characterized by severe optic neuritis and transverse myelitis, usually with a relapsing course. Aquaporin-4 antibody is positive in a high percentage of NMO patients and it is directed against this water channel richly expressed on foot processes of astrocytes. Due to the severity of NMO attacks and the high risk for disability, treatment should be instituted as soon as the diagnosis is confirmed. There is increasing evidence that NMO patients respond differently from patients with multiple sclerosis (MS), and, therefore, treatments for MS may not be suitable for NMO. Acute NMO attacks usually are treated with high dose intravenous corticosteroid pulse and plasmapheresis. Maintenance therapy is also required to avoid further attacks and it is based on low-dose oral corticosteroids and non-specific immunosuppressant drugs, like azathioprine and mycophenolate mofetil. New therapy strategies using monoclonal antibodies like rituximab have been tested in NMO, with positive results in open label studies. However, there is no controlled randomized trial to confirm the safety and efficacy for the drugs currently used in NMO.

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Different responses to interferon beta‐1b treatment in patients with neuromyelitis optica and multiple sclerosis

Abstract: IFNB-1b treatment does not appear to be effective for preventing relapse in NMO likely because of differences between the immune-pathogenesis of NMO and MS.

Cited by 92 publications

References 16 publications

Influence of female sex and fertile age on neuromyelitis optica spectrum disorders

Influence of female sex and fertile age on neuromyelitis optica spectrum disorders

Present and Future Therapies in Neuromyelitis Optica Spectrum Disorders

Treatment of neuromyelitis optica: an evidence based review

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