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Interferon-β and serum 25-hydroxyvitamin D interact to modulate relapse risk in MS

Citation

Stewart, N and Simpson Jr, S and van der Mei, I and Ponsonby, A-L and Blizzard, L and Dwyer, T and Pittas, F and Eyles, D and Ko, P and Taylor, BV, Interferon-β and serum 25-hydroxyvitamin D interact to modulate relapse risk in MS, Neurology, 79, (3) pp. 254-260. ISSN 0028-3878 (2012) [Refereed Article]


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Copyright 2012 AAN Enterprises

DOI: doi:10.1212/WNL.0b013e31825fded9

Abstract

Objective: To determine whether interferon-β (IFN-β) medication use is associated with vitamin D levels and whether the two interact in exerting effects on relapse risk.

Methods: In a prospective cohort of 178 persons with clinically definite multiple sclerosis (MS) living in southern Tasmania in 20022005, serum 25-hydroxyvitamin D [25(OH)D] was measured biannually, with assessment by questionnaire for relevant factors, including IFN-β treatment.

Results: Subjects reporting IFN-β use had significantly higher mean 25(OH)D than persons who did not (P<0.001). This was mediated by an interaction between personal sun exposure and IFN-β, with treated persons realizing nearly three times 25(OH)D per hour of sun exposure of persons not on therapy. The association between 25(OH)D and 1,25-dihydroxyvitamin D did not differ by IFN-β therapy (P=0.82). 25(OH)D was associated with a reduced relapse risk only among persons on IFN-β (P<0.001). Importantly, IFN-β was only protective against relapse among persons with higher 25(OH)D (hazard ratio [HR] 0.58 [95% confidence interval (CI) 0.350.98]), while among 25(OH)D-insufficient persons, IFN-β increased relapse risk (HR 2.01 [95% CI 1.223.32]).

Conclusion: In this study, we found that IFN-β therapy is associated with greater production of vitamin D from sun exposure, suggesting part of the therapeutic effects of IFN-β on relapse in MS may be through modulation of vitamin D metabolism. These findings suggest persons being treated with IFN-β should have vitamin D status monitored and maintained in the sufficiency range.

Classification of evidence: This study provided Class III evidence that IFN-β is associated with reduced risk of relapse, and this effect may be modified by a positive effect of IFN-β on serum 25(OH)D levels.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Epidemiology
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Nervous System and Disorders
Author:Stewart, N (Dr Niall Stewart)
Author:Simpson Jr, S (Dr Steve Simpson JR)
Author:van der Mei, I (Associate Professor Ingrid van der Mei)
Author:Blizzard, L (Associate Professor Leigh Blizzard)
Author:Pittas, F (Dr Fotini Pittas)
Author:Taylor, BV (Professor Bruce Taylor)
ID Code:78830
Year Published:2012
Web of Science® Times Cited:41
Deposited By:Menzies Institute for Medical Research
Deposited On:2012-07-30
Last Modified:2015-08-07
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