Objectives: To prospectively investigate the associations of baseline serum anti-phospholipid antibody (APLA) status on evolution of clinical and MRI measures in a multiple sclerosis (MS) patient cohort treated with interferon-beta (IFN-beta).
Methods: Forty-seven relapsing-remitting (RR) MS patients, [26 APLA-positive (APLA(+)) and 21 APLA-negative (APLA(-))] matched for age, sex, disease duration, MRI characteristics, disability, and time on IFN-beta treatment, were enrolled. All patients were on intramuscular (IM) IFN-beta1a for at least 3 years and remained on the same treatment over the 3-year duration of the study.
Results: The APLA(+) group accumulated significantly higher T2-LV over the 3-year follow-up than the APLA(-) group (+31% versus -1·1%, P = 0·043). The MTR of T1-LV (-3·3% versus +4·7%, P = 0·04) in the APLA(+) group was lower compared to the APLA(-) group. At 3-year follow-up, the APLA(+) group had increased tissue damage as measured by diffusion entropy (+4% versus -2·5%, P = 0·019) and whole brain volume loss (-0·69% versus -0·37%, P = 0·041), compared to the APLA(-) group. There were more clinical relapses in the MS APLA(+) group compared to APLA(-) patients (18 versus 10) and a higher frequency of sustained disability progression (7/26 or 27% versus 2/21 or 9·5%).
Conclusions: This study suggests that APLA(+) RRMS patients treated with IFN-beta1a develop more severe MRI and clinical deterioration. Future studies are required to evaluate the role of APLA as potential biomarkers for disease prognosis versus predictors for therapeutic response to IFN-beta therapy.
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