Interferon β-1b and glatiramer acetate effects on permanent black hole evolution

M. Filippi, M. A. Rocca, F. Camesasca, S. Cook, P. O'Connor, B. G W Arnason, L. Kappos, D. Goodin, D. Jeffery, H. P. Hartung, G. Comi, J. S. Wolinsky, T. Bogumil, C. Pohl, K. Beckmann, R. Sandbrink, E. Croze, C. Brown, T. M. Desimone, D. L. ArnoldG. Cutter, V. Knappertz

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To compare interferon β-1b (IFNβ-1b) and glatiramer acetate (GA) on new lesion (NL) (gadolinium-enhancing, new T2) evolution into permanent black holes (PBH)-a marker of irreversible tissue damage-in patients with relapsing-remitting multiple sclerosis (RRMS). Methods: BEYOND was a large, phase III, clinical trial comparing IFNβ-1b 250 μg, IFNβ-1b 500 μg, and GA (2:2:1). Patient scans were reexamined post hoc for PBH in a rater-blinded manner. Two predefined coprimary endpoints compared IFNβ-1b 250 μg with GA: first, number of PBH per patient at year 2 evolving from year 1 NL, then proportion of year 1 NL evolving into PBH at year 2. IFNβ-1b 500 μg and GA were compared in an exploratory fashion. Results: Approximately 90% (1,957/2,244) of patients had NL at year 1 with follow-up at year 2. Mean numbers of PBH per patient at year 2 evolving from year 1 NL were lower for IFNβ-1b 250 μg than GA (0.30 vs 0.43; p = 0.0451). The proportion of NL evolving into PBH was similar (IFNβ-1b 250 μg vs GA: 21.6% vs 23.5%; p > 0.20). For IFNβ-1b 500 μg, both the mean PBH number per patient at year 2 evolving from year 1 NL (0.26 vs 0.43; p = 0.0037) and proportion of NL evolving into PBH (16.3% vs 23.5%; p = 0.0409) were lower relative to GA. Conclusion: IFNβ-1b affected PBH development to a similar or better extent than GA. IFNβ-1b favorably influences an MRI outcome indicative of permanent tissue destruction in the brains of patients with multiple sclerosis. Classification of evidence: This study provides Class III evidence that IFNβ-1b is associated with a reduction in MRI PBH formation and evolution compared with GA between years 1 and 2 of treatment.

Original languageEnglish
Pages (from-to)1222-1228
Number of pages7
JournalNeurology
Volume76
Issue number14
DOIs
Publication statusPublished - Apr 5 2011

ASJC Scopus subject areas

  • Clinical Neurology

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