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

Stewart, Niall, Simpson, Steve Jr., van der Mei, Ingrid, Ponsonby, Anne-Louise, Blizzard, Leigh, Dwyer, Terrence, Pittas, Fotini, Eyles, Darryl, Ko, Pauline and Taylor, Bruce V. (2012) Interferon-β and serum 25-hydroxyvitamin D interact to modulate relapse risk in MS. Neurology, 79 3: 254-260. doi:10.1212/WNL.0b013e31825fded9

Author Stewart, Niall
Simpson, Steve Jr.
van der Mei, Ingrid
Ponsonby, Anne-Louise
Blizzard, Leigh
Dwyer, Terrence
Pittas, Fotini
Eyles, Darryl
Ko, Pauline
Taylor, Bruce V.
Title Interferon-β and serum 25-hydroxyvitamin D interact to modulate relapse risk in MS
Journal name Neurology   Check publisher's open access policy
ISSN 0028-3878
Publication date 2012-06-13
Sub-type Article (original research)
DOI 10.1212/WNL.0b013e31825fded9
Open Access Status Not Open Access
Volume 79
Issue 3
Start page 254
End page 260
Total pages 7
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted 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 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.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online before print: June 13 2012.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Queensland Brain Institute Publications
Official 2013 Collection
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Citation counts: TR Web of Science Citation Count  Cited 40 times in Thomson Reuters Web of Science Article | Citations
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Created: Fri, 13 Jul 2012, 00:01:46 EST by Debra McMurtrie on behalf of Queensland Brain Institute