Wednesday, 23 November 2011

Africans and interferon-beta treatment response

Jeannin et al. Response to interferon-Beta treatment in afro-caribbeans with multiple sclerosis. Mult Scler Int. 2011;2011:950126.

Background: MS patients of African ancestry have a more aggressive disease course than white patients and could be resistant to interferon-beta (INFB).

Methods: We studied the impact of INFB in treatment-naive Afro-Caribbean (AC) with clinically definite MS using our European Database for Multiple Sclerosis (EDMUS) (2003-2010). Main outcome measures were annual relapse rate after 2 years of treatment, proportion of exacerbation-free subjects 48 weeks after initiating INFB, and time to first relapse.
Results: 76 AC-MS (59F/17M) were identified. Annual relapse rate of 1.29 decreased to 0.83 (-35.6%) after 2 years of treatment. The proportion of relapse-free patients at 48 weeks was 46.2%. Median time to first relapse was 52 weeks.

Conclusion: INFB is not strong enough to control AC-MS patients in many cases which is problematic in a population of worse MS prognosis.

"These results need to be confirmed; we have a lot of Afro-Caribbeans living in the UK and the second and third generation, or the offspring of the original migrant population, are at high-risk of MS."

"In London, and other areas of the country, there are large numbers of Afro-Caribbeans on IFN-beta. The message is simple; if you are IFN-beta and having break-through disease it is time to switch to something else."

5 comments:

  1. Could this be down to genes?

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  2. This is an interesting area of debate.

    Dr. Cord Spilker and his colleagues at Bradford St. Luke's Hospital are undertaking a study measuring the severity of MS in the local South Asian population, for whom they believe disease is pathologically more aggressive than in the Caucasian community.

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  3. Re: genes

    Yes. Almost certainly, but could be related to some cultural factors that relate to acceptance of disease and medications. For example subjects with less active or benign disease may be less likely to be on treatment. This will bias the results.

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  4. Do you have any more details about the Dr. Spilker study? I'd be very much interested in finding out more about it, as I'm an Asian with MS.

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  5. @ Asian with MS

    From what I know this study is part funded by the MS Society and is being prep'd at the moment.

    Bradford obviously has a high Asisn population with MS, but other few areas in the UK with big Asian communities may also be part of the study.

    You're best off contacting St. Luke's for more info.

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