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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Methods: In a prospective cohort of 178 persons with clinically definite multiple sclerosis (MS) living in southern Tasmania in 2002–2005, 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) 0.35–0.98]), while among 25(OH)D-insufficient persons, IFN-β increased relapse risk (HR 2.01 [95% CI 1.22–3.32]).
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 Type:||Refereed Article|
|Research Division:||Medical and Health Sciences|
|Research Group:||Public Health and Health Services|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Nervous System and Disorders|
|UTAS Author:||Stewart, N (Dr Niall Stewart)|
|UTAS Author:||Simpson Jr, S (Dr Steve Simpson JR)|
|UTAS Author:||van der Mei, I (Associate Professor Ingrid van der Mei)|
|UTAS Author:||Blizzard, L (Professor Leigh Blizzard)|
|UTAS Author:||Pittas, F (Dr Fotini Pittas)|
|UTAS Author:||Taylor, BV (Professor Bruce Taylor)|
|Web of Science® Times Cited:||52|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||1 View Download Statistics|
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