Opinion: IgM+ patients should not be treated with interferon

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Opinion: IgM+ patients should not be treated with interferon

Postby frodo » Fri Jul 27, 2018 12:25 am

MS patients present oligoclonal bands (OCB) in their cerebrospinal fluid (CSF). Among the oligoclonal bands there could be some related to immunoglobin M (IgM). These bands will be called oligoclonal-M bands (OCMB) and are present in about 50% of the patients (IgM+ patients, OCMB+ patients).

This study treated some of them with interferon beta (IFNβ) and others with Glatimer acetate (GA). Treatment decision was made blinded to the OCMB status.

The proportion of relapse-free patients (RF) was higher in the GA group than in the IFNβ group (72% vs. 40%) but the poor performance of IFNβ was due mainly to the OCMB+ patients. Only 31% of them responded to interferon, vs. 48% of response for OCMB-negative group.

The authors do not say it explicitly but for me it is clear after these results that IgM+ patients should be treated always with GA instead of IFNβ.

Source:

Different clinical response to interferon beta and glatiramer acetate related to the presence of oligoclonal IgM bands in CSF in multiple sclerosis patients

https://link.springer.com/article/10.10 ... 018-3442-y

Objective

To study the efficacy of interferon beta (IFNβ) and glatiramer acetate (GA) related to the presence of oligoclonal M bands (OCMB) in the cerebrospinal fluid in relapsing-remitting multiple sclerosis (RRMS).

Method

This is an observational, multicenter and retrospective study with prospectively collected data of patients that started treatment with IFNβ or GA. Treatment decision was made blinded to the OCMB status. Time to first attack after starting therapy was compared by using Kaplan-Meier curves, and adjustment by Cox regression analysis was performed.

Results

Two hundred and fifty-six patients entered in the study (141–55% received IFNβ; 115–45% received GA). After a mean follow-up of 41 and 65 months, 54.7% of patients remained free from further attacks (RF). The proportion of RF patients was higher in the GA group than in the IFNβ group (72.2 vs. 40.4%, p < 0.001). The IFNβ patients with OCMB+ presented the poorest response, 31.3% RF vs. 48.1% in IFNβ without OCMB, p = 0.03.

Conclusion

OCMB in CSF could be a biomarker of treatment response in multiple sclerosis.
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frodo
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