Effects of inhibitors of the renin-angiotensin system on the efficacy of interferon beta-1b

A post hoc analysis of the beyond study

M. Doerner, K. Beckmann, V. Knappertz, L. Kappos, H. P. Hartung, M. Filippi, P. W. O'Connor, B. Arnason, S. Cook, D. Jeffery, G. Comi, V. Limmroth

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: In experimental autoimmune encephalomyelitis, inhibition of the renin-angiotensin system with angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme (ACE) inhibitors resulted in a significantly ameliorated disease course. We evaluated the effects of ARBs and ACE inhibitors on the efficacy of interferon beta-1b in patients with relapsing-remitting multiple sclerosis (RRMS). Methods: In this post hoc analysis of the BEYOND (Betaferon Efficacy Yielding Outcomes of a New Dose) study, clinical and MRI end points were compared between patients treated with interferon beta-1b 250 or 500 μg and concomitant ARBs or ACE inhibitors and patients treated with interferon beta-1b 250 or 500 μg only (reference group). Results: Patients in the ARB group (n = 22) tended to have a higher relapse rate (0.48 vs. 0.23, p = 0.051) and a higher number of new gadolinium-enhancing lesions (0.6 vs. 0.3, p = 0.057) than patients in the reference group. Patients in the ACE inhibitor group (n = 49) also tended to have a higher relapse rate (0.29 vs. 0.22, p = 0.357). No differences were observed for the other end points. Conclusion: In the BEYOND study cohort, a concomitant medication with ARBs or ACE inhibitors did not have a beneficial effect in patients with RRMS treated with interferon beta-1b. As patients appeared to have a higher relapse rate, our results warrant further investigation.

Original languageEnglish
Pages (from-to)173-179
Number of pages7
JournalEuropean Neurology
Volume71
Issue number3-4
DOIs
Publication statusPublished - 2014

Fingerprint

Renin-Angiotensin System
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Relapsing-Remitting Multiple Sclerosis
Recurrence
Autoimmune Experimental Encephalomyelitis
Interferon beta-1b
Gadolinium
Cohort Studies

Keywords

  • Angiotensin receptor blockers
  • Angiotensin-converting enzyme inhibitors
  • BEYOND study
  • Cardiovascular comorbidity
  • Hypertension
  • Immune system
  • Interferon beta
  • Multiple sclerosis
  • Renin-angiotensin system

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Effects of inhibitors of the renin-angiotensin system on the efficacy of interferon beta-1b : A post hoc analysis of the beyond study. / Doerner, M.; Beckmann, K.; Knappertz, V.; Kappos, L.; Hartung, H. P.; Filippi, M.; O'Connor, P. W.; Arnason, B.; Cook, S.; Jeffery, D.; Comi, G.; Limmroth, V.

In: European Neurology, Vol. 71, No. 3-4, 2014, p. 173-179.

Research output: Contribution to journalArticle

Doerner, M, Beckmann, K, Knappertz, V, Kappos, L, Hartung, HP, Filippi, M, O'Connor, PW, Arnason, B, Cook, S, Jeffery, D, Comi, G & Limmroth, V 2014, 'Effects of inhibitors of the renin-angiotensin system on the efficacy of interferon beta-1b: A post hoc analysis of the beyond study', European Neurology, vol. 71, no. 3-4, pp. 173-179. https://doi.org/10.1159/000355530
Doerner, M. ; Beckmann, K. ; Knappertz, V. ; Kappos, L. ; Hartung, H. P. ; Filippi, M. ; O'Connor, P. W. ; Arnason, B. ; Cook, S. ; Jeffery, D. ; Comi, G. ; Limmroth, V. / Effects of inhibitors of the renin-angiotensin system on the efficacy of interferon beta-1b : A post hoc analysis of the beyond study. In: European Neurology. 2014 ; Vol. 71, No. 3-4. pp. 173-179.
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abstract = "Background: In experimental autoimmune encephalomyelitis, inhibition of the renin-angiotensin system with angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme (ACE) inhibitors resulted in a significantly ameliorated disease course. We evaluated the effects of ARBs and ACE inhibitors on the efficacy of interferon beta-1b in patients with relapsing-remitting multiple sclerosis (RRMS). Methods: In this post hoc analysis of the BEYOND (Betaferon Efficacy Yielding Outcomes of a New Dose) study, clinical and MRI end points were compared between patients treated with interferon beta-1b 250 or 500 μg and concomitant ARBs or ACE inhibitors and patients treated with interferon beta-1b 250 or 500 μg only (reference group). Results: Patients in the ARB group (n = 22) tended to have a higher relapse rate (0.48 vs. 0.23, p = 0.051) and a higher number of new gadolinium-enhancing lesions (0.6 vs. 0.3, p = 0.057) than patients in the reference group. Patients in the ACE inhibitor group (n = 49) also tended to have a higher relapse rate (0.29 vs. 0.22, p = 0.357). No differences were observed for the other end points. Conclusion: In the BEYOND study cohort, a concomitant medication with ARBs or ACE inhibitors did not have a beneficial effect in patients with RRMS treated with interferon beta-1b. As patients appeared to have a higher relapse rate, our results warrant further investigation.",
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T2 - A post hoc analysis of the beyond study

AU - Doerner, M.

AU - Beckmann, K.

AU - Knappertz, V.

AU - Kappos, L.

AU - Hartung, H. P.

AU - Filippi, M.

AU - O'Connor, P. W.

AU - Arnason, B.

AU - Cook, S.

AU - Jeffery, D.

AU - Comi, G.

AU - Limmroth, V.

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AB - Background: In experimental autoimmune encephalomyelitis, inhibition of the renin-angiotensin system with angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme (ACE) inhibitors resulted in a significantly ameliorated disease course. We evaluated the effects of ARBs and ACE inhibitors on the efficacy of interferon beta-1b in patients with relapsing-remitting multiple sclerosis (RRMS). Methods: In this post hoc analysis of the BEYOND (Betaferon Efficacy Yielding Outcomes of a New Dose) study, clinical and MRI end points were compared between patients treated with interferon beta-1b 250 or 500 μg and concomitant ARBs or ACE inhibitors and patients treated with interferon beta-1b 250 or 500 μg only (reference group). Results: Patients in the ARB group (n = 22) tended to have a higher relapse rate (0.48 vs. 0.23, p = 0.051) and a higher number of new gadolinium-enhancing lesions (0.6 vs. 0.3, p = 0.057) than patients in the reference group. Patients in the ACE inhibitor group (n = 49) also tended to have a higher relapse rate (0.29 vs. 0.22, p = 0.357). No differences were observed for the other end points. Conclusion: In the BEYOND study cohort, a concomitant medication with ARBs or ACE inhibitors did not have a beneficial effect in patients with RRMS treated with interferon beta-1b. As patients appeared to have a higher relapse rate, our results warrant further investigation.

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