PL EN


Preferences help
enabled [disable] Abstract
Number of results
2010 | 10 | 3 | 134 - 144
Article title

Analiza przebiegu choroby oraz zmian w obrazie rezonansu magnetycznego mózgu i rdzenia szyjnego u chorych na stwardnienie rozsiane leczonych interferonem beta, octanem glatirameru

Content
Title variants
EN
Analysis of disease course and of change in MRI scans of the brain and of the cervical spinal cord treated with beta interferons, glatiramer acetate
Languages of publication
EN PL
Abstracts
EN
Multiple sclerosis (MS) is a chronic disease of the central nervous system, it is the main cause of “non-injury” disability in the young adults’ population. As shown in clinical studies, the disease course may be changed by so-called disease modifying drugs (DMD): beta-interferons (IFN-β-1a and IFN-β-1b) as well as glatiramer acetate (GA). The purpose of this work was to analyse the course of the disease and changes in magnetic resonance imaging (MRI) scans of the brain and of the cervical spinal cord in patients with relapsing-remitting multiple sclerosis (RRMS) during a 2-year DMD therapy. The following therapies were evaluated: IFN-β-1b (250 μg), IFN-β-1a (44 mg), IFN-β-1a (30 μg) and GA (20 mg). The study duration was 24 months. The study was performed in 118 patients with RRMS. Mean patient age was 29.0±8.6 (18-50) years with disease duration of 3.4±1.6 years. The patients were treated as follows: 20 patients received IFN-β-1a (30 μg), 40 – IFN-β-1b (250 μg), 33 – IFN-β-1a (44 μg) and 25 – GA (20 mg). The female patients predominated in the study group – 66.1%. EDSS score before treatment was 2.3±0.9. The annualised relapse rate (ARR) for the entire study group was 0.82. The study showed similar effects of particular drugs on the evaluated parameters. After 2-year treatment the EDSS value was 2.6±1.3 points (an increase by 0.3 points). The value of the ARR decreased to 0.55 (a reduction by 32.9%). A significant difference in disease progression was found in MRI scans: at 1 year in 87.0% patients without progression and 42.9% patients in 2 year. The results of this study showed the following: similar effects of particular drugs, treatment with disease modifying drugs has a stabilising effect on disability progression only in some patients, a favourable effect of DMD on slow-down of the disease duration was observed during the second year of treatment and the relapses are the most important clinical indicator of disease unresponsiveness.
PL
Stwardnienie rozsiane (łac. sclerosis multiplex, SM) to przewlekła choroba ośrodkowego układu nerwowego, stanowi też główną przyczyną niepełnosprawności (nieurazowej) w populacji młodych dorosłych. Lekami, które zgodnie z wynikami badań klinicznych mają wpływ na przebieg choroby, są: interferony beta (IFN-β-1a i IFN-β-1b) oraz octan glatirameru (GA). Celem pracy była analiza przebiegu choroby oraz zmian w obrazie rezonansu magnetycznego (RM) mózgu i rdzenia szyjnego u chorych z postacią rzutowo-remisyjną stwardnienia rozsianego (RRSM) u chorych w przebiegu 2-letniej terapii lekami immunomodulującymi (DMD): IFN-β-1b (250 μg), IFN-β-1a (44 μg), IFN-β-1a (30 μg) oraz GA (20 mg). Badanie trwało 24 miesiące. Materiał kliniczny stanowiło 118 chorych z RRSM. Grupa chorych, u których włączono leczenie, to: 20 osób leczonych IFN-β-1a (30 μg), 40 – IFN-β-1b (250 μg), 33 – IFN-β-1a (44 μg) i 25 – GA (20 mg). W badanej grupie przeważały kobiety – 66,1%. Średni wiek chorych wynosił 29,0±8,6 (18-50) roku; wartość EDSS w chwili rozpoczęcia leczenia – 2,3±0,9 pkt; roczny wskaźnik rzutów (ARR) – 0,82. W badaniu stwierdzono podobny wpływ poszczególnych leków na oceniane parametry. Po dwóch latach leczenia wartość EDSS wyniosła 2,6±1,3 pkt (wzrost o 0,3 pkt). Zaobserwowano zmniejszenie rocznego wskaźnika rzutów (ARR) do 0,55 (redukcja o 32,9%). Stwierdzono wyraźną różnicę progresji choroby w ocenie RM – po pierwszym roku progresję stwierdzono u 87,0% chorych, po drugim roku leczenia – u 42,9%. Wyniki przeprowadzonych badań wskazują, że badane leki działają podobnie na postęp choroby, leczenie DMD wpływa stabilizująco na narastanie niesprawności tylko u części chorych, korzystny wpływ leczenia immunomodulującego obserwowano szczególnie w drugim roku leczenia, a obecność nowych rzutów choroby w trakcie kuracji jest najważniejszym klinicznym wykładnikiem braku odpowiedzi na leczenie.
Discipline
Year
Volume
10
Issue
3
Pages
134 - 144
Physical description
Contributors
  • Klinika Neurologiczna, 10. Wojskowy Szpital Kliniczny z Polikliniką SP ZOZ, ul. Powstańców Warszawy 5, 85-681 Bydgoszcz, tel.: 52 378 61 46
  • Klinika Neurologiczna, 10. Wojskowy Szpital Kliniczny z Polikliniką SP ZOZ
References
  • 1. Frohman E.M., Racke M.K., Raine C.S.: Multiple sclerosis - the plaque and its pathogenesis. N. Engl. J. Med. 2006; 354: 942-955.
  • 2. Trapp B.D., Peterson J., Ransohoff R.M. i wsp.: Axonal transection in the lesions of multiple sclerosis. N. Engl. J. Med. 1998; 338: 278-285.
  • 3. Bar-Or A.: The immunology of multiple sclerosis. Neurol. Clin. 2005; 23: 149-175.
  • 4. Minagar A., Alexander J.S.: Blood-brain barrier disruption in multiple sclerosis. Mult. Scler. 2003; 9: 540-549.
  • 5. McDonald WI., Compston A., Edan G. i wsp.: Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann. Neurol. 2001; 50: 121-127.
  • 6. Polman C.H., Reingold S.C., Edan G. i wsp.: Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”. Ann. Neurol. 2005; 58: 840-846.
  • 7. Miller D., Filippi M., Fazekas F. i wsp.: Role of magnetic resonance imaging within diagnostic criteria for multiple sclerosis. Ann. Neurol. 2004; 56: 273-278.
  • 8. Matthews P.M.: An update on neuroimaging of multiple sclerosis. Curr. Opin. Neurol. 2004; 17: 453-458.
  • 9. IFNB Multiple Sclerosis Study Group. Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. I. Clinical results of a multicenter, randomized, double-blind, placebo-controlled trial. Neurology 1993; 43: 655-661.
  • 10. Johnson K.P., Brooks B.R., Cohen J.A. i wsp.: Copolymer 1 reduces relapse rate and improves disability in relapsing-remitting multiple sclerosis: results of a phase III multicenter, double-blind placebo-controlled trial. The Copolymer 1 Multiple Sclerosis Study Group. Neurology 1995; 45: 1268-1276.
  • 11. Jacobs L.D., Cookfair D.L., Rudick R.A. i wsp.: Intramuscular intrferon beta-1a for disease progression in relapsing multiple sclerosis. The Multiple Sclerosis Collaborative Research Group (MSCRG). Ann. Neurol. 1996; 39: 285-294.
  • 12. PRISMS study group. Randomized double-blind placebo controlled study of interferon B-1a in relapsing/remitting multiple sclerosis. Lancet 1998; 352: 1498-1504.
  • 13. Kidd D., Thorpe J.W., Thompson A.J. i wsp.: Spinal cord MRI using multi-array coils and fast spin echo. II. Findings in multiple sclerosis. Neurology 1993; 43: 2632-2637.
  • 14. Fazekas F., Offenbacher H., Fuchs S. i wsp.: Criteria for and increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis. Neurology 1988; 38: 1822-1825.
  • 15. The Once Weekly Interferon for MS Study Group: Evidence of interferon B-1a dose response in relapsing-remitting MS: the OWIMS Study. Neurology 1999; 53: 679-686.
  • 16. Stanisz A.: Przystępny kurs statystyki w oparciu o program Statistica PL na przykładach z medycyny. StatSoft, Kraków 1998.
  • 17. O’Riordan J.I., Gawne C.M. Coles A. i wsp.: T1 hypointense lesion load in secondary progressive multiple sclerosis: a comparison of pre versus post contrast loads and of manual versus semi automated threshold techniques for lesion segmentation. Mult. Scler. 1998; 4: 408-414.
  • 18. Nijeholt G.J., van Walderveen M.A., Castelijns J.A. i wsp.: Brain and spinal cord abnormalities in multiple sclerosis. Correlation between MRI parameters, clinical subtypes and symptoms. Brain 1998; 121: 687-697.
  • 19. Losseff N.A., Wang L., Lai H.M. i wsp.: Progressive cerebral atrophy in multiple sclerosis. A serial MRI study. Brain 1996: 119: 2009-2019.
  • 20. Giugni E., Pozzilli C., Bastianello S. i wsp.: MRI measures and their relations with clinical disability in relapsing-remitting and secondary progressive multiple sclerosis. Mult. Scler. 1997; 3: 221-225.
  • 21. Brex P.A., Ciccarelli O., O’Riordan J.I. i wsp.: A longitudinal study of abnormalities on MRI and disability from multiple sclerosis. N. Engl. J. Med. 2002; 346: 158-164.
  • 22. Heinzlef O., Ramanan K., Tehindrazanarivelo A.D. i wsp.: Criteria for non-response to interferon in relapsing-remitting multiple sclerosis: a nation-wide survey. Mult. Scler. 2005: 11: 157-168.
  • 23. Boneschi F.M., Rovaris M., Johson K.P. i wsp.: Effect of glatiramer acetate on relapse rate and accumulated disability in multiple sclerosis: meta-analysis of three double-blind, randomized, placebo-controlled clinical trials. Mult. Scler. 2003: 9: 349-355.
  • 24. Ford C.C., Johnson K.P., Lisak R.P. i wsp.; Copaxone Study Group: A prospective open-label study of glatiramer acetate: over a decade of continuous use in multiple sclerosis patients. Mult. Scler. 2006; 12: 309-320.
  • 25. Niezgodzińska-Maciejek A., Maciejek Z.: Wstępna ocena leczenia interferonem beta-1a (REBIF) w postaci rzutowej stwardnienia rozsianego. Biul. Wojsk. Szpit. Klin. Bydg. 1998: 3: 97-99.
  • 26. Limmroth V, Malessa R., Zettl U.K. i wsp.: Quality Assessment in Multiple Sclerosis Therapy (QUASIMS): a comparison of interferon beta therapies for relapsing-remitting multiple sclerosis. J. Neurol. 2007; 254: 67-77.
  • 27. Thorpe J.W, Kidd D., Moseley I.F. i wsp.: Serial gadolinium-enhanced MRI of the brain and spinal cord in early relapsing-remitting multiple sclerosis. Neurology 1996; 46: 373-378.
  • 28. Ślotała T., Kurkiewicz T., Maciejek Z.: Analiza różnic w obrazowaniu MRI mózgu i rdzenia szyjnego w postaci rzutowej i pierwotnie postępującej stwardnienia rozsianego. Valetudinaria - Post. Med. Klin. Wojsk. 2003; 8: 20-24.
  • 29. Miller D.H., Albert P.S., Barkhof F. i wsp.: Guidelines for the use of magnetic resonance techniques in monitoring the treatment of multiple sclerosis. US National MS Society Task Force. Ann. Neurol. 1996; 39: 6-16.
  • 30. International Working Group for Treatment Optimization in MS. Treatment optimization in multiple sclerosis: report of an international consensus meeting. Eur. J. Neurol. 2004; 11: 43-47.
  • 31. Li D.K., Paty D.W: Magnetic resonance imaging results of the PRISMS trial: a randomized, double-blind, placebo-controlled study of interferon-beta la in relapsing-remitting multiple sclerosis. Prevention of Relapses and Disability by Interferon beta-la Subcutaneously in Multiple Sclerosis. Ann. Neurol. 1999; 46: 197-206.
  • 32. Comi G., Filippi M., Wolinsky J.S. i wsp.: European/Canadian multicenter, double-blind, randomized, placebo-controlled study of the effects of glatiramer acetate on magnetic resonance imaging - measured disease activity and burden in patients with relapsing multiple sclerosis. Ann. Neurol. 2001; 49: 290-297.
  • 33. McFarland H.F., Frank J.A., Albert P.S. i wsp.: Using gadolinium-enhanced magnetic resonance imaging lesions to monitor disease activity in multiple sclerosis. J. Neurol. Neu-rosurg. Psychiatry 1999; 66: 465-469.
  • 34. Sormani M.P., Molyneux P.D., Gasperini C. i wsp.: Statistical power of MRI monitored trials in multiple sclerosis new data and comparison with previous results. J. Neurol. Neurosurg. Psychiatry 1999; 66: 465-469.
  • 35. Rudick R.A., Lee J.C., Simon J., Fisher E.: Significance of T2 lesions in multiple sclerosis: a 13-year longitudinal study. Ann. Neurol. 2006; 60: 236-242.
  • 36. Miller D.H., Barkhof F., Frank J.A. i wsp.: Measurement of atrophy in multiple sclerosis: pathological basis, methodological aspects and clinical relevance. Brain 2002; 125: 1676-1695.
  • 37. Miller D.H., Grossman R.I., Reingold S.C., McFarland H.F.: The role of magnetic resonance techniques in understanding and managing multiple sclerosis. Brain 1998; 121: 3-24.
  • 38. Bonneville F., Moriarty D.M., Li B.S. i wsp.: Whole-brain N-acetylaspartate concentration: correlation with T2-weighted lesion volume and expanded disability status scale score in cases of relapsing-remitting multiple sclerosis. AJRN Am. J. Neuroradiol. 2002; 23: 371-375.
  • 39. Rovaris M., Agosta F., Sormani M.P. i wsp.: Conventional and magnetization transfer MRI predictors of clinical multiple sclerosis evolution: a medium-term follow-up study. Brain 2003; 126: 2323-2332.
  • 40. Miller D.H., Barkhof F., Berry I. i wsp.: Magnetic resonance imaging in monitoring the treatment of multiple sclerosis: concerted action guidelines. J. Neurol. Neurosurg. Psychiatry 1991; 54: 683-688.
  • 41. Tedeschi G., Gallo A.: Multiple sclerosis patients and immunomodulation therapies: the potential role of new techniques to assess responders versus non-responders. Neurol. Sci. 2005; 26: 209-212.
  • 42. Jacobs L.D., Beck R.W, Simon J.H. i wsp.: Intramuscular interferon beta-1a therapy initiated during a first demyelinating event in multiple sclerosis. CHAMPS Study Group. N. Engl. J. Med. 2000; 343: 898-904.
  • 43. Comi G., Filippi M., Barkhof F. i wsp.; Early Treatment of Multiple Sclerosis Study Group.: Effect of early interferon treatment on conversion to definite multiple sclerosis: a randomized study. Lancet 2001; 357: 1576-1582.
  • 44. Kappos L., Freedman M.S., Polman C.H. i wsp.; BENEFIT Study Group.: Effect of early versus delayed interferon beta-1b treatment on disability after a first clinical event suggestive of multiple sclerosis: a 3-year follow-up analysis of the BENEFIT study. Lancet 2007; 370: 389-397.
  • 45. Comi G., Carra A., Fazekas F. i wsp.: Treatment with glatiramer acetate delays conversion to clinically definite multiple sclerosis in patients with clinically isolated syndrome: subgroup analyses. Mult. Scler. 2008; 14 (supl. 1): 38.
  • 46. Selmaj K., Członkowska A., Kwieciński H. i wsp.: Badanie otwarte oceny skuteczności interferonu beta 1A (Avonex) w stwardnieniu rozsianym. Ocena kliniczna z wykorzystaniem testów parametrycznych funkcji ruchowych i koordynacyjnych. Neurol. Neurochir. Pol. 2003; 37: 1163-1183.
  • 47. Mikol D.D., Barkhof F., Chang P. i wsp.; REGARD study group: Comparison of subcutaneous interferon beta-1a with glatiramer acetate in patients with relapsing multiple sclerosis (the REbif vs Glatiramer Acetate in Relapsing MS Disease [REGARD] study): a multicentre, randomised, parallel, open-label trial. Lancet Neurol. 2008; 7: 903-914.
  • 48. Cadavid D., Wolansky L., Cook S. i wsp.: Betaseron (IFN-1b) vs Copaxone (glatiramer acetate) in MS with triple-dose gadolinium and 3T MRI endpoints (BECOME): announcement of final primary study outcome. Mult. Scler. 2007; 12 (supl. 2): 58.
  • 49. O’Connor P., Filippi M., Arnason B. i wsp.: 250 jug or 500 ,ug interferon beta-1b versus 20 mg glatiramer acetate in relapsing-remitting multiple sclerosis: a prospective, randomised, multicentre study. Lancet Naurol. 2009; 8: 889-897.
Document Type
article
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.psjd-010d4944-ee78-4906-94c8-b424c8cf3ee5
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.