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Magnetization transfer ratio in new MS lesions before and during therapy with IFNß-1a

From the UCSF/Mt. Zion Multiple Sclerosis Center (Drs. Kita, Goodkin, and Waubant), UCSF Department of Epidemiology and Biostatistics (Dr. Bacchetti), and UCSF Department of Radiology (Drs. Nelson and Majumdar), University of California at San Francisco.

Address correspondence and reprint requests to Dr. Donald E. Goodkin, 1701 Divisadero St., Suite 480, San Francisco, CA 94115.

OBJECTIVE: The authors examined the effect of 6.0 MIU interferon beta-1a (IFNß-1a) administered IM each week on the evolution of monthly magnetization transfer ratio (MTR) within new gadolinium-enhancing (Gd+) lesions in patients with very early relapsing-remitting (RR) MS.

BACKGROUND: IFNß is an effective disease-modifying treatment for patients with RRMS. Among other effects, it has been shown to decrease the number of new Gd+ and T2-weighted lesions. MTR is a putative marker for irreversible tissue damage and evolution of MTR within a lesion may reflect recovery of tissue damage. It is not known whether IFNß-1a affects the recovery phase of lesions.

METHODS: Eight untreated patients with RRMS who completed up to 14 monthly brain MRI sessions elected to initiate treatment with IFNß-1a. Four out of eight patients developed new Gd+ lesions during treatment. MTR of lesions at the time of appearance and subsequent rate of change of monthly MTR were compared before and after treatment (stratified Mann-Whitney test).

RESULTS: The difference between MTR at appearance of 47 new Gd+ lesions before treatment versus 23 new Gd+ lesions during treatment was not significant. Twenty-two of 47 new Gd+ lesions before treatment and 11 of 23 new Gd+ lesions after treatment were monitored for up to 6 months. After appearance of new Gd+ lesions, the rate of increase in MTR was faster during therapy (p = 0.037).

CONCLUSION: MTR abnormalities within new Gd+ lesions evolve at a faster rate during treatment with IFNß-1a than before initiating therapy. This is consistent with the hypothesis that IFNß-1a promotes resolution of new Gd+ lesions.

Key words: Magnetization transfer ratio—MS lesions—Interferon beta-1a

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