A. Cornea, R. Tudor, A. Petre and M. Simu

 ABSTRACT

Background and purpose. Interferon beta (IFN beta) belongs to the first line of disease modifying therapy drugs in the treatment of relapsing-remitting multiple sclerosis being widely used in the chronic treatment of this pathology. The serum presence of the neutralizing antibodies (Nabs) has been shown to alter the treatment response, its routine applicability being still debated. In an observational study, we aimed to determine in the Nabs positive patients, correlations with other clinical factors which contribute to IFN beta decreased efficacy.
Methods. We measured Nabs in 104 patients who were on IFN beta therapy (29.8% on IFN beta 1a s.c., 27.88% on IFN beta 1a i.m. and 42,3 on IFN beta 1b s.c.) for at least one year in our clinic. Serum was collected at 24 h after treatment injection to avoid transitory antibody peak (12-18 h post administration). We considered positive the patients with a titer higher than 20 TRU.
Results. The prevalence of Nabs in our group of patients was 13.43% (42.85% IFN Beta 1b s.c., 50% IFN beta 1a s.c. and 7.14% IFN beta 1 a i.m.). Nabs positivity was associated with an increase in the relapse rate (for IFB beta 1a and 1b s.c. groups) and progression for IFN beta 1 b s.c. patient group.
Conclusions. The routine clinical testing for Nabs should impact the clinical decision of switching therapy in multiple sclerosis patients that present with an increased number of relapses, EDSS progression or a higher number of MRI T2 lesions.

Keywords: Multiple sclerosis, neutralizing antibodies (Nabs), interferon beta (IFN beta)

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A. Cornea, C. Dijmarescu, R. Tudor, A. Petre and M. Simu

 ABSTRACT

Introduction. Multiple sclerosis is a neurodegenerative disease for which correct prevalence and incidence data are mandatory to assess the long term health policy in terms of social and economic burden. The present study aims to evaluate the prevalence of MS and the distribution of clinical MS forms in Timis County, a region inhabited by 3.39% of the Romanian stable population according to the 2011 Romanian census, and is meant as a sample of the national situation. There have been no previous attempts to assess the MS prevalence status in Timis County.
Material and methods. This study was conducted in a well-defined geographical area (i.e the Timis County which lies in the Western region of Romania) exploring the prevalence of MS and the patients’clinical profile. The information regarding MS patients was obtained using hospital records and the files of the patients treated and followed up in the Romanian National MS Program for treatment of MS.
Results. The crude calculated prevalence was 53.6 per 100,000 inhabitants. The F:M ratio was 1.7 corresponding to a number of 220 (65.4%) females and 116 (34.5%) males.
Discussions. This study is the first attempt to estimate the prevalence of multiple sclerosis in Timis County as part of an ongoing project of the National Romanian Society of Neurology to build up the Romanian MS Registry and our results indicate higher prevalence values than expected, fact due to an increased diagnostic accuracy provided by clear cut diagnosis criteria and MRI standardized magnetic resonance imagery procedures currently available.

Keywords: epidemiology, multiple sclerosis, prevalence

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