Gender effects on treatment response to interferon-beta in multiple sclerosis

Acta Neurol Scand. 2014 Dec;130(6):374-9. doi: 10.1111/ane.12277. Epub 2014 Sep 10.

Abstract

Background: Gender appears to play a role in incidence and disease course of multiple sclerosis (MS).

Objective: The objective was to determine whether male and female patients with MS respond differently to interferon-beta treatment in terms of reduction in relapse rates.

Methods: We included all 2033 patients with relapsing-remitting MS who started treatment with interferon-beta from 1996 to 2003, identified from the Danish Multiple Sclerosis Treatment Register. We defined neutralizing antibody (NAb)-positive and NAb-negative periods in the single patient by the results of the NAb tests. Patients served as their own controls, and relapse rates were compared between NAb-negative and NAb-positive periods.

Results: NAbs significantly abrogated the interferon-beta treatment efficacy in both genders. The all-over women:men relapse rate ratio irrespective of NAb status was 1.47 (95%CI; 1.28-1.68). In a generalized linear Poisson models analysis with relapse counts as response variable, the main effects NAbs, sex, age at treatment start and number of relapses in 2 years before treatment start were strongly significant, but the effect of NAbs on relapse rates did not differ significantly between men and women.

Conclusion: As NAbs influenced the on-treatment relapse rates strongly in both sexes but without statistical significant difference, there is no indication of different effects of interferon-beta in men or women.

Keywords: Demyelinating diseases; gender differences; immunomodulatory treatment; interferon; multiple sclerosis; neutralizing antibodies; treatment response.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Neutralizing / blood*
  • Disease Progression
  • Female
  • Humans
  • Immunologic Factors / therapeutic use*
  • Interferon-beta / therapeutic use*
  • Male
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / blood
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Recurrence
  • Sex Characteristics*
  • Treatment Outcome
  • Young Adult

Substances

  • Antibodies, Neutralizing
  • Immunologic Factors
  • Interferon-beta