#MSBlog: Are you on interferon-beta? Have you been tested for NABs?
Biopharmaceuticals are drugs which are based on naturally occurring proteins.. Immunogenicity of these agents has been commonly described and refers to a specific antidrug antibody response. Such immunogenicity represents a major factor impairing the efficacy of biopharmaceuticals due to biopharmaceutical neutralization. Indeed, clinical experience has shown that induction of antidrug antibodies is associated with a loss of response to biopharmaceuticals and also with hypersensitivity reactions. The first disease-specific agent licensed to treat MS was interferon-β (IFNβ). In its various preparations, it remains the most commonly used first-line agent. The occurrence of antidrug antibodies has been extensively researched in MS, particularly in relation to IFNβ. However, much controversy remains regarding the significance of these antibodies and incorporation of testing into clinical practice. Between 2% and 45% of people treated with IFNβ will develop neutralizing antibodies, and this is dependent on the specific drug and dosing regimen. The aim of this review is to discuss the use of IFNβ in MS, the biological and clinical relevance of anti-IFNβ antibodies (binding and neutralizing antibodies), the incorporation of testing in clinical practice and ongoing research in the field.
"This review raises the issue of neutralising antibodies to interferon beta or NABs yet again. Some of you may say not again. However, this is a serious issue and needs to be taken seriously. If you are on interferon beta you should have yourself tested to see if you are NAB positive. MSers who are NAB positive do much worse than those who are NAB negative. NABs not only stop interferon -beta from working they probably neutralise the activity of your own interferon beta with potential long-term consequences. This is why we have a study underway to try and get rid of NABs."
"We are interested to know how common NABs testing is amongst readers of this blog, which is why we would appreciate you completing the following poll. If you have been on IFNbeta for 12 months or longer you should ask your neurologist whether or not he/she thinks a NABs test is necessary."
CoI: Paul Creeke and Rachel Farrell work at Barts and UCL; i.e. they are members of MS@UCLP