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[PMID]:28556498
[Au] Autor:Fitzgerald KC; Munger KL; Hartung HP; Freedman MS; Montalbán X; Edan G; Wicklein EM; Radue EW; Kappos L; Pohl C; Ascherio A; BENEFIT Study Group
[Ad] Endereço:Department of Neurology and Neuroimmunology, Johns Hopkins School of Medicine, Baltimore, MA.
[Ti] Título:Sodium intake and multiple sclerosis activity and progression in BENEFIT.
[So] Source:Ann Neurol;82(1):20-29, 2017 Jul.
[Is] ISSN:1531-8249
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess whether a high-salt diet, as measured by urinary sodium concentration, is associated with faster conversion from clinically isolated syndrome (CIS) to multiple sclerosis (MS) and MS activity and disability. METHODS: BENEFIT was a randomized clinical trial comparing early versus delayed interferon beta-1b treatment in 465 patients with a CIS. Each patient provided a median of 14 (interquartile range = 13-16) spot urine samples throughout the 5-year follow-up. We estimated 24-hour urine sodium excretion level at each time point using the Tanaka equations, and assessed whether sodium levels estimated from the cumulative average of the repeated measures were associated with clinical (conversion to MS, Expanded Disability Status Scale [EDSS]) and magnetic resonance imaging (MRI) outcomes. RESULTS: Average 24-hour urine sodium levels were not associated with conversion to clinically definite MS over the 5-year follow-up (hazard ratio [HR] = 0.91, 95% confidence interval [CI] = 0.67-1.24 per 1g increase in estimated daily sodium intake), nor were they associated with clinical or MRI outcomes (new active lesions after 6 months: HR = 1.05, 95% CI = 0.97-1.13; relative change in T2 lesion volume: -0.11, 95% CI = -0.25 to 0.04; change in EDSS: -0.01, 95% CI = -0.09 to 0.08; relapse rate: HR = 0.78, 95% CI = 0.56-1.07). Results were similar in categorical analyses using quintiles. INTERPRETATION: Our results, based on multiple assessments of urine sodium excretion over 5 years and standardized clinical and MRI follow-up, suggest that salt intake does not influence MS disease course or activity. Ann Neurol 2017;82:20-29.
[Mh] Termos MeSH primário: Doenças Desmielinizantes/diagnóstico
Esclerose Múltipla/diagnóstico
Sódio na Dieta/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Encéfalo/patologia
Doenças Desmielinizantes/tratamento farmacológico
Doenças Desmielinizantes/patologia
Doenças Desmielinizantes/urina
Avaliação da Deficiência
Progressão da Doença
Feminino
Seres Humanos
Interferon beta-1b/uso terapêutico
Imagem por Ressonância Magnética
Masculino
Neuroimagem
Sódio na Dieta/urina
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Sodium, Dietary); 145155-23-3 (Interferon beta-1b)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170531
[St] Status:MEDLINE
[do] DOI:10.1002/ana.24965


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[PMID]:28104258
[Au] Autor:Drulovic J; Cukic M; Grgic S; Dincic E; Raicevic R; Nadj C; Toncev G; Vojinovic S; Mesaros S; Kisic Tepavcevic D; Dujmovic I; Tadic D; Miletic-Drakulic S; Dackovic J; Kostic S; Erakovic J; Sakalas L; Savic D; Suknjaja V; Martinovic V; Maric G; Pekmezovic T
[Ad] Endereço:Clinic of Neurology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Dr Subotica 6, Belgrade 11000, Serbia. Electronic address: jelena60@eunet.rs.
[Ti] Título:The impact of betaplus program on patient treatment satisfaction with interferon beta-1b in multiple sclerosis: Multicentric cross-sectional survey in the western Balkan countries.
[So] Source:Mult Scler Relat Disord;11:56-61, 2017 Jan.
[Is] ISSN:2211-0356
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Long-term treatment adherence to disease-modifying drugs (DMDs) may have significant impact on clinical outcomes in multiple sclerosis (MS). It has been recently emphasized that low treatment satisfaction (TS) may be an important factor for achieving high rates of treatment adherence. Interferon (IFN) beta-1b was the first DMD approved for the treatment of MS. The aims of our study were to assess TS in subjects with relapsing-remitting (RR) MS treated with IFN beta-1b in Serbia, Montenegro and the Republika Srpska, Bosnia and Herzegovina (B&H), and additionally, to evaluate the impact of patient support program on TS and adherence. METHODS: This is a cross-sectional survey performed in order to examine TS and adherence with IFN beta-1b in seven MS centers across three countries (Serbia, Montenegro and B&H). Included in the study were 296 adult patients with RRMS treated with IFN beta-1b for at least 6 months. They were invited to complete the Treatment Satisfaction Questionnaire for Medication (TSQM). Additional two treatment adherence questions were also asked. Patient support program (Betaplus®) was available exclusively for patients in Serbia and not for those in Montenegro and the Republika Srpska, B&H. In order to assess the potential impact of this program on TSQM, we combined two groups of patients from Montenegro and B&H and compared their results with those from patients in Serbia. Statistical analysis includes multivariable linear regression analysis in order to assess the differences between three MS patients groups in terms of the TSQM scores, adjusted for potential confounders. For the evaluation of the effects of Betaplus® program, multivariable logistic regression was used, controlling for the same confounding factors. RESULTS: Each of the TSQM summary scores in all three countries implicated high level of patients' satisfaction. There was statistically significant group difference on the Effectiveness summary score (p=0.001) and the Side effects summary score (p=0.006) between the group of subjects from Serbia and the combined group of subjects from Montenegro and B&H, in favor of the former cohort. There was statistically significant group difference neither on the Convenience summary score nor on the Overall satisfaction summary score. Results of adjusted logistic regression analysis based on the availability of patient support program (dependent variable) implicate that it had the most significant impact on the Effectiveness summary score (p=0.008). According to the correlation coefficients in the total patient cohort, all TSMQ summary scores except Effectiveness significantly correlated with the decreased adherence (Side effects: p=0.037; Convenience: p=0.016; Overall satisfaction: p=0.046). CONCLUSION: TS with IFN beta-1b was high in our MS patients. Additionally, these results have demonstrated that patient support program have significant impact on TS with IFN beta-1b in the Balkan cohort of RRMS patients.
[Mh] Termos MeSH primário: Adjuvantes Imunológicos/uso terapêutico
Interferon beta-1b/uso terapêutico
Adesão à Medicação/psicologia
Esclerose Múltipla/tratamento farmacológico
Esclerose Múltipla/psicologia
Satisfação do Paciente
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Bósnia e Herzegóvina/epidemiologia
Estudos Transversais
Avaliação da Deficiência
Feminino
Seres Humanos
Modelos Lineares
Modelos Logísticos
Masculino
Adesão à Medicação/estatística & dados numéricos
Meia-Idade
Montenegro/epidemiologia
Esclerose Múltipla/epidemiologia
Análise Multivariada
Satisfação do Paciente/estatística & dados numéricos
Sérvia/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Adjuvants, Immunologic); 145155-23-3 (Interferon beta-1b)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170227
[Lr] Data última revisão:
170227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170121
[St] Status:MEDLINE


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[PMID]:27885448
[Au] Autor:Cinar BP; Kösehasanogullari G; Yigit P; Ozakbas S
[Ad] Endereço:Department of Neurology, Samsun Training and Research Hospital, Samsun, Turkey. bilge.cinarpiri@gmail.com.
[Ti] Título:Cognitive dysfunction in patients with multiple sclerosis treated with first-line disease-modifying therapy: a multi-center, controlled study using the BICAMS battery.
[So] Source:Neurol Sci;38(2):337-342, 2017 Feb.
[Is] ISSN:1590-3478
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:Multiple sclerosis (MS) can impair cognitive functions even in the early stages. The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery is very short and highly sensitive and can be used to evaluate cognitive status in the disease. Several clinical trials have shown beneficial effects of disease-modifying drugs (DMDs) on long-term cognitive measures which may even reduce cognitive deficits in MS patients. Relapsing remitting MS patients using DMDs were enrolled in the study and monitored for 12 months. BICAMS and the Expanded Disability Status Scale were applied to the study group. We evaluated and monitored 161 newly diagnosed cases of definite MS by the end of the trial. 110 patients (68.2%) were female. One hundred and two healthy subjects (female to male ratio 68:34) were enrolled into the study. MS patients were categorized into three DMT groups: IFNB1-a SC, IFNB1-b, and GA. Mean scores of all three cognitive tests (SDMT, BVMT-R, and CVLT-II) were significantly higher in the control group than in the MS patients. The number of cognitively impaired patients decreased from 31.7 to 21.7% on the basis of CVLT (p = 0.024), and 42 (26.1%) to 30 (18.6%) on the basis of BVMT-R at month 12. A significant difference was determined in terms of cognitive status between MS patients using both IFNB and GA and the healthy control group. Ours is the first study to compare IFNB and GA in terms of evaluating cognitive involvement and to use the BICAMS battery in monitoring treatment.
[Mh] Termos MeSH primário: Disfunção Cognitiva/tratamento farmacológico
Fatores Imunológicos/farmacologia
Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico
Avaliação de Resultados (Cuidados de Saúde)
Índice de Gravidade de Doença
[Mh] Termos MeSH secundário: Adulto
Disfunção Cognitiva/etiologia
Feminino
Acetato de Glatiramer/administração & dosagem
Acetato de Glatiramer/farmacologia
Seres Humanos
Fatores Imunológicos/administração & dosagem
Interferon beta-1a/administração & dosagem
Interferon beta-1a/farmacologia
Interferon beta-1b/administração & dosagem
Interferon beta-1b/farmacologia
Masculino
Esclerose Múltipla Recidivante-Remitente/complicações
Método Simples-Cego
Adulto Jovem
[Pt] Tipo de publicação:CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Immunologic Factors); 145155-23-3 (Interferon beta-1b); 5M691HL4BO (Glatiramer Acetate); XRO4566Q4R (Interferon beta-1a)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161126
[St] Status:MEDLINE
[do] DOI:10.1007/s10072-016-2775-7


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[PMID]:27833991
[Au] Autor:Zvonova EA; Ershov AV; Ershova OA; Sudomoina MA; Degterev MB; Poroshin GN; Eremeev AV; Karpov AP; Vishnevsky AY; Goldenkova-Pavlova IV; Petrov AV; Ruchko SV; Shuster AM
[Ad] Endereço:International Biotechnology Center (IBC) "Generium", Vladimirskaya street 14, Volginsky village, Petushinsky district, Vladimir Region, 601125, Russia. berkovich@ibcgenerium.ru.
[Ti] Título:PASylation technology improves recombinant interferon-ß1b solubility, stability, and biological activity.
[So] Source:Appl Microbiol Biotechnol;101(5):1975-1987, 2017 Mar.
[Is] ISSN:1432-0614
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Recombinant interferon-ß1b (IFN-ß1b) is an effective remedy against multiple sclerosis and other diseases. However, use of small polypeptide (molecular weight is around 18.5 kDa) is limited due to poor solubility, stability, and short half-life in systemic circulation. To solve this problem, we constructed two variants of PASylated IFN-ß1b, with PAS sequence at C- or N-terminus of IFN-ß1b. The PAS-modified proteins demonstrated 4-fold increase in hydrodynamic volume of the molecule combined with 2-fold increase of in vitro biological activity, as well as advanced stability and solubility of the protein in solution as opposed to unmodified IFN-ß1b. Our results demonstrate that PASylation has a positive impact on stability, solubility, and functional activity of IFN-ß1b and potentially might improve pharmacokinetic properties of the molecule as a therapeutic agent.
[Mh] Termos MeSH primário: Fatores Imunológicos/metabolismo
Interferon beta-1b/genética
Interferon beta-1b/metabolismo
Processamento de Proteína Pós-Traducional
Proteínas Recombinantes/metabolismo
[Mh] Termos MeSH secundário: Meia-Vida
Seres Humanos
Fatores Imunológicos/genética
Fatores Imunológicos/uso terapêutico
Interferon beta-1b/uso terapêutico
Esclerose Múltipla/tratamento farmacológico
Estabilidade Proteica
Proteínas Recombinantes/genética
Proteínas Recombinantes/uso terapêutico
Solubilidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Immunologic Factors); 0 (Recombinant Proteins); 145155-23-3 (Interferon beta-1b)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170227
[Lr] Data última revisão:
170227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161112
[St] Status:MEDLINE
[do] DOI:10.1007/s00253-016-7944-3


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[PMID]:28078290
[Au] Autor:Niedziela N; Adamczyk-Sowa M; Niedziela JT; Mazur B; Kluczewska E; Sowa P; Gasior M
[Ad] Endereço:Department of Neurology in Zabrze, Medical University of Silesia, ul. 3-go Maja 13-15, 41-800 Zabrze, Poland.
[Ti] Título:Assessment of Serum Nitrogen Species and Inflammatory Parameters in Relapsing-Remitting Multiple Sclerosis Patients Treated with Different Therapeutic Approaches.
[So] Source:Biomed Res Int;2016:4570351, 2016.
[Is] ISSN:2314-6141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The role of nitric oxide and its reactive derivatives (NO ) is well known in the pathogenesis of multiple sclerosis, which is an inflammatory disease while NO seems to be important in coordinating inflammatory response. The purpose of the present study was to assess serum NO as one of the nitrogen species and inflammatory parameters in relapsing-remitting multiple sclerosis patients and to compare the effectiveness of various types of disease-modifying therapies that reduce nitric oxide and inflammatory biomarkers. Elevated NO level was observed in patients who received the first-line disease-modifying therapy (interferons beta-1a and beta-1b) in comparison with the subjects treated with the second-line disease-modifying therapy (natalizumab; fingolimod) and healthy controls without significant differences in C-reactive protein and interleukin-1 beta. A negative correlation was observed between serum NO level and the duration of multiple sclerosis confirmed in the whole study population and in subjects treated with the first-line agents. Only serum NO , concentration could reveal a potential efficacy of disease-modifying therapy with a better reduction in NO level due to the second-line agents of disease-modifying therapy.
[Mh] Termos MeSH primário: Inflamação/sangue
Inflamação/tratamento farmacológico
Esclerose Múltipla/sangue
Esclerose Múltipla/tratamento farmacológico
Espécies Reativas de Nitrogênio/sangue
[Mh] Termos MeSH secundário: Adolescente
Adulto
Biomarcadores/sangue
Cloridrato de Fingolimode/administração & dosagem
Seres Humanos
Inflamação/patologia
Interferon beta-1a/administração & dosagem
Interferon beta-1a/metabolismo
Interferon beta-1b/administração & dosagem
Interferon beta-1b/metabolismo
Meia-Idade
Esclerose Múltipla/patologia
Natalizumab/administração & dosagem
Óxido Nítrico/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Natalizumab); 0 (Reactive Nitrogen Species); 145155-23-3 (Interferon beta-1b); 31C4KY9ESH (Nitric Oxide); G926EC510T (Fingolimod Hydrochloride); XRO4566Q4R (Interferon beta-1a)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170224
[Lr] Data última revisão:
170224
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170113
[St] Status:MEDLINE
[do] DOI:10.1155/2016/4570351


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[PMID]:27919507
[Au] Autor:Moccia M; Palladino R; Carotenuto A; Russo CV; Triassi M; Lanzillo R; Brescia Morra V
[Ad] Endereço:Multiple Sclerosis Clinical Care and Research Center, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy. Electronic address: moccia.marcello@gmail.com.
[Ti] Título:Predictors of long-term interferon discontinuation in newly diagnosed relapsing multiple sclerosis.
[So] Source:Mult Scler Relat Disord;10:90-96, 2016 Nov.
[Is] ISSN:2211-0356
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Interferon-ß has long-term safety and efficacy profiles for Relapsing Remitting Multiple Sclerosis (RRMS). However, the increasing number of available treatments requires to improve patient profiling and to perform individualized clinical decisions. Therefore, the present study investigated predictors of Interferon-ß discontinuation. METHODS: The present retrospective observational cohort study included 499 newly diagnosed, drug naïve RRMS subjects receiving Interferon-ß as first disease modifying treatment (DMT), during a 7.9±3.8 year period, up to treatment discontinuation. Possible markers of interest were recorded at the time of diagnosis (age, gender, disease duration, baseline EDSS) or during follow-up as variables of disease evolution (relapse occurrence, annualized relapse rate -ARR-, 1-point EDSS progression, reaching of EDSS 4.0) or of treatment (high-dose Interferon-ß1a, low-dose Interferon-ß1a, or Interferon-ß1b). RESULTS: 217 patients (43.5%) discontinued the treatment during the follow-up period, with an incidence of 5% person-years (95%CI=4.6-5.9%). A multivariate Cox regression model showed an increased rate of Interferon-ß discontinuation for female gender (p=0.019; HR=1.428), higher baseline EDSS (p=0.026; HR=1.346), relapse occurrence (p=0.009; HR=1.618), higher ARR (p<0.001; HR=5.269), and Interferon-ß1b treatment (p=0.019; HR=1.506); and a reduced rate for occurrence of EDSS progression (p<0.001; HR=0.299). CONCLUSIONS: Most of the factors associated with Interferon-ß discontinuation are not modifiable, and are part of demographic features (i.e. gender), or of disease characteristics (i.e. disability at diagnosis), but should be taken into account when prescribing the first DMT for MS. Noteworthy, the use of Interferon-ß1b is associated with 50% increased risk of discontinuation, compared with high-dose Interferon-ß1a, highlighting the importance of drug formulations in treatment persistence.
[Mh] Termos MeSH primário: Fatores Imunológicos/uso terapêutico
Interferon beta-1a/uso terapêutico
Interferon beta-1b/uso terapêutico
Adesão à Medicação
Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico
Esclerose Múltipla Recidivante-Remitente/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Avaliação da Deficiência
Feminino
Seguimentos
Seres Humanos
Incidência
Estimativa de Kaplan-Meier
Estudos Longitudinais
Masculino
Esclerose Múltipla Recidivante-Remitente/diagnóstico
Análise Multivariada
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Immunologic Factors); 145155-23-3 (Interferon beta-1b); XRO4566Q4R (Interferon beta-1a)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170228
[Lr] Data última revisão:
170228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161207
[St] Status:MEDLINE


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[PMID]:27880972
[Au] Autor:La Mantia L; Di Pietrantonj C; Rovaris M; Rigon G; Frau S; Berardo F; Gandini A; Longobardi A; Weinstock-Guttman B; Vaona A
[Ad] Endereço:Unit of Neurorehabilitation - Multiple Sclerosis Center, I.R.C.C.S. Santa Maria Nascente - Fondazione Don Gnocchi, Via Capecelatro, 66, Milano, Italy, 20148.
[Ti] Título:Interferons-beta versus glatiramer acetate for relapsing-remitting multiple sclerosis.
[So] Source:Cochrane Database Syst Rev;11:CD009333, 2016 11 24.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Interferons-beta (IFNs-beta) and glatiramer acetate (GA) were the first two disease-modifying therapies (DMTs) approved 20 years ago for the treatment of multiple sclerosis (MS). DMTs' prescription rates as first or switching therapies and their costs have both increased substantially over the past decade. As more DMTs become available, the choice of a specific DMT should reflect the risk/benefit profile, as well as the impact on quality of life. As MS cohorts enrolled in different studies can vary significantly, head-to-head trials are considered the best approach for gaining objective reliable data when two different drugs are compared. The purpose of this systematic review is to summarise available evidence on the comparative effectiveness of IFNs-beta and GA on disease course through the analysis of head-to-head trials.This is an update of the Cochrane review 'Interferons-beta versus glatiramer acetate for relapsing-remitting multiple sclerosis' (first published in the Cochrane Library 2014, Issue 7). OBJECTIVES: To assess whether IFNs-beta and GA differ in terms of safety and efficacy in the treatment of people with relapsing-remitting (RR) MS. SEARCH METHODS: We searched the Trials Register of the Cochrane Multiple Sclerosis and Rare Diseases of the CNS Group (08 August 2016) and the reference lists of retrieved articles. We contacted authors and pharmaceutical companies. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing directly IFNs-beta versus GA in study participants affected by RRMS. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures as expected by Cochrane. MAIN RESULTS: Six trials were included and five trials contributed to this review with data. A total of 2904 participants were randomly assigned to IFNs (1704) and GA (1200). The treatment duration was three years for one study, two years for the other four RCTs while one study was stopped early (after one year). The IFNs analysed in comparison with GA were IFN-beta 1b 250 mcg (two trials, 933 participants), IFN-beta 1a 44 mcg (three trials, 466 participants) and IFN-beta 1a 30 mcg (two trials, 305 participants). Enrolled participants were affected by active RRMS. All studies were at high risk for attrition bias. Three trials are still ongoing, one of them completed.Both therapies showed similar clinical efficacy at 24 months, given the primary outcome variables (number of participants with relapse (risk ratio (RR) 1.04, 95% confidence interval (CI) 0.87 to 1.24) or progression (RR 1.11, 95% CI 0.91 to 1.35). However at 36 months, evidence from a single study suggests that relapse rates were higher in the group given IFNs than in the GA group (RR 1.40, 95% CI 1.13 to 1.74, P value 0.002).Secondary magnetic resonance imaging (MRI) outcomes analysis showed that effects on new or enlarging T2- or new contrast-enhancing T1 lesions at 24 months were similar (mean difference (MD) -0.15, 95% CI -0.68 to 0.39, and MD -0.14, 95% CI -0.30 to 0.02, respectively). However, the reduction in T2- and T1-weighted lesion volume was significantly greater in the groups given IFNs than in the GA groups (MD -0.58, 95% CI -0.99 to -0.18, P value 0.004, and MD -0.20, 95% CI -0.33 to -0.07, P value 0.003, respectively).The number of participants who dropped out of the study because of adverse events was similar in the two groups (RR 0.95, 95% CI 0.64 to 1.40).The quality of evidence for primary outcomes was judged as moderate for clinical end points, but for safety and some MRI outcomes (number of active T2 lesions), quality was judged as low. AUTHORS' CONCLUSIONS: The effects of IFNs-beta and GA in the treatment of people with RRMS, including clinical (e.g. people with relapse, risk to progression) and MRI (Gd-enhancing lesions) measures, seem to be similar or to show only small differences. When MRI lesion load accrual is considered, the effect of the two treatments differs, in that IFNs-beta were found to limit the increase in lesion burden as compared with GA. Evidence was insufficient for a comparison of the effects of the two treatments on patient-reported outcomes, such as quality-of-life measures.
[Mh] Termos MeSH primário: Adjuvantes Imunológicos/uso terapêutico
Acetato de Glatiramer/uso terapêutico
Interferon beta-1a/uso terapêutico
Interferon beta-1b/uso terapêutico
Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico
[Mh] Termos MeSH secundário: Seres Humanos
Imagem por Ressonância Magnética
Esclerose Múltipla Recidivante-Remitente/diagnóstico por imagem
Esclerose Múltipla Recidivante-Remitente/patologia
Ensaios Clínicos Controlados Aleatórios como Assunto
Recidiva
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Adjuvants, Immunologic); 145155-23-3 (Interferon beta-1b); 5M691HL4BO (Glatiramer Acetate); XRO4566Q4R (Interferon beta-1a)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170111
[Lr] Data última revisão:
170111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161124
[St] Status:MEDLINE


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[PMID]:27828855
[Au] Autor:Wencel-Warot A; Michalak S; Warot M; Kalinowska-Lyszczarz A; Kazmierski R
[Ad] Endereço:aDepartment of Developmental Neurology, Poznan University of Medical Sciences, Przybyszewskiego bDepartment of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Przybyszewskiego cDepartment of General and Vascular Surgery and Angiology, Poznan University of Medical Sciences, prof. L. Bierkowski Hospital dDepartment of Neurology and Cerebrovascular Disorders, Poznan University of Medical Sciences, prof. L. Bierkowski Hospital, Poznan, Poland.
[Ti] Título:The cross-reactivity of binding antibodies with different interferon beta formulations used as disease-modifying drugs in multiple sclerosis patients.
[So] Source:Medicine (Baltimore);95(45):e5337, 2016 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Interferon beta (IFNb) preparations are commonly used as first-line therapy in relapsing-remitting multiple sclerosis (RRMS). They are, however, characterized by limited efficacy, partly due to the formation of anti-IFNb antibodies in patients.In this pilot study, we assessed with the ELISA method the presence of the binding antibodies (BAbs) against interferon beta after 2 years of therapy with subcutaneous interferon beta 1a (Rebif) in 49 RRMS patients. Antibody levels were established again within 1 year after treatment withdrawal. We used 3 interferons that are commercially available for MS therapy, namely Avonex (Biogen Idec Limited), Rebif (Merck Serono), and Betaferon (Bayer Pharma AG), as antigens.BAbs reacting with Rebif were found in 24.4% to 55% of patients, depending on the units of their expression. The levels of anti-Rebif antibodies remained high in 8 patients and in 4 patients they dropped significantly. Strong correlations were obtained in all assays (anti-Rebif-anti-Avonex, anti-Rebif-anti-Betaferon, and anti-Betaferon-anti-Avonex) and the existence of cross-reactivity in the formation of antibodies against all the tested formulations of interferon beta was confirmed. The levels of BAbs remain significant in the clinical context, and their assessment is the first choice screening; however, methods of BAbs evaluation can be crucial for further decisions. More studies are needed to confirm our results; specifically it would be of interest to evaluate methods of neutralizing antibodies identification, as we only assessed the binding antibodies. Nevertheless, our results support the concept that in interferon nonresponders, that are positive for binding antibodies, switching the therapy to alternative disease-modifying agent (for example glatiramer acetate, fingolimod, or natalizumab) is justified, whereas the switch to another interferon formulation will probably be of no benefit.
[Mh] Termos MeSH primário: Anticorpos/imunologia
Interferon beta-1a/imunologia
Interferon beta-1a/uso terapêutico
Interferon beta-1b/imunologia
Interferon beta-1b/uso terapêutico
Interferon beta/imunologia
Interferon beta/uso terapêutico
Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico
Esclerose Múltipla Recidivante-Remitente/imunologia
[Mh] Termos MeSH secundário: Adulto
Reações Cruzadas
Feminino
Seres Humanos
Masculino
Projetos Piloto
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Antibodies); 145155-23-3 (Interferon beta-1b); 77238-31-4 (Interferon-beta); XRO4566Q4R (Interferon beta-1a)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170224
[Lr] Data última revisão:
170224
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161110
[St] Status:MEDLINE


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[PMID]:27749097
[Au] Autor:Perlman B; Heller D; Cracchiolo B
[Ad] Endereço:a Departments of Obstetrics , Gynecology, and Women's Health, Rutgers-New Jersey Medical School , Newark , NJ , USA.
[Ti] Título:Interferon beta-1b-induced postmenopausal bleeding in a patient with multiple sclerosis.
[So] Source:Climacteric;19(6):599-600, 2016 Dec.
[Is] ISSN:1473-0804
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Postmenopausal bleeding must always be evaluated to rule out endometrial carcinoma, although there are many benign etiologies. There have been rare reports of premenopausal bleeding with interferon beta-1b, used to treat multiple sclerosis, but no prior reports in postmenopausal women. METHODS: Literature searches were performed using PubMed and Medline for articles with content related to premenopausal and postmenopausal bleeding while taking interferon beta-1b. The searches were restricted to the English language. Search terms included interferon beta-1b and/or uterine hemorrhage and/or vaginal bleeding and/or postmenopausal and/or menopause. RESULTS: The literature review found no related articles for postmenopausal bleeding while taking interferon beta-1b. We present a case of a patient with postmenopausal bleeding attributed to elevation of serum estradiol in association with interferon beta-1b therapy. CONCLUSION: It is important for patients and providers to be aware of the association between postmenopausal bleeding with the use of interferon beta-1b therapy which could be due to elevated serum estradiol levels.
[Mh] Termos MeSH primário: Interferon beta-1b/efeitos adversos
Esclerose Múltipla/tratamento farmacológico
Pós-Menopausa
Hemorragia Uterina/induzido quimicamente
[Mh] Termos MeSH secundário: Estradiol/sangue
Feminino
Seres Humanos
Interferon beta-1b/uso terapêutico
MEDLINE
Meia-Idade
Pós-Menopausa/sangue
Hemorragia Uterina/sangue
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
145155-23-3 (Interferon beta-1b); 4TI98Z838E (Estradiol)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161018
[St] Status:MEDLINE


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[PMID]:27695075
[Au] Autor:Jernas L; Wencel J; Wiak A; Bieniek M; Bartosik-Psujek H
[Ad] Endereço:Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland.
[Ti] Título:Risk Factors for Poor Adherence to Betaferon® Treatment in Patients with Relapsing-Remitting Multiple Sclerosis or Clinically Isolated Syndrome.
[So] Source:PLoS One;11(10):e0157950, 2016.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Adherence to treatment, including early treatment discontinuation, in patients with multiple sclerosis or clinically isolated syndrome can be affected by: treatment tolerability, route of drug administration, patient age, disease duration, comorbidities, medical care, and support from their caregivers. AIM: This study aimed to identify the risk factors for poor adherence to Betaferon® treatment, including early discontinuation and omitting doses. MATERIALS AND METHODS: 852 adult patients treated with Betaferon participated in this 24-month study. All patients were interviewed using the Risk of Drop-out Questionnaire, the Center for Epidemiologic Studies Depression Scale and the Kurtzke Expanded Disability Status Scale. RESULTS: Patients who stopped therapy were younger (p = 0.003) had a higher mean EDSS score (p = 0.022), higher mean number of relapses (p = 0.017), and reported more often fear of injection (p = 0.027) and adverse events (p = 0.007) than those who did not stop treatment. Comparing patients who stopped therapy in the first and the second year, patients who stopped therapy in the first year of treatment more frequently reported flu-like symptoms and fever, and those who stopped therapy in the second year reported-ineffectiveness of treatment and disease progression. Multivariable logistic regression models confirmed that young age, short disease duration, advanced and progressing disease, and poor Betaferon tolerability were related to premature treatment discontinuation. The risk of omitting a dose during therapy was increased in patients who were working or studying, who had more advanced disease or more adverse events, and in patients who received less support from their caregivers. CONCLUSIONS: Several reasons may lead to problems with adherence to Betaferon treatment. Patients at higher risk of discontinuing treatment need to be identified early to make caregivers' support available to them.
[Mh] Termos MeSH primário: Adjuvantes Imunológicos/uso terapêutico
Interferon beta-1b/uso terapêutico
Adesão à Medicação/estatística & dados numéricos
Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Depressão/psicologia
Progressão da Doença
Seres Humanos
Modelos Logísticos
Masculino
Esclerose Múltipla Recidivante-Remitente/psicologia
Fatores de Risco
Inquéritos e Questionários
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adjuvants, Immunologic); 145155-23-3 (Interferon beta-1b)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170614
[Lr] Data última revisão:
170614
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161004
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0157950



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