シミズ　ユウコ   Shimizu Yuuko   清水　優子    所属   医学部 医学科（東京女子医科大学病院）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Therapeutic efficacy of interferon β-1b in Japanese patients with optic-spinal multiple sclerosis.
掲載誌名	正式名：The Tohoku journal of experimental medicine 略　 称：Tohoku J Exp Med ISSNコード：13493329/00408727
掲載区分	国外
巻・号・頁	223(3),pp.211-２１４
著者・共著者	Shimizu Yuko
担当区分	筆頭著者,責任著者
発行年月	2011/03
概要	Optic neuritis and myelitis are manifestations in both multiple sclerosis (MS) and neuromyelitis optica (NMO). But unlike MS, NMO is characterized by severe optic neuritis, longitudinally extensive and transverse myelitis, and the presence of aquaporin-4 antibody. Since patients with optic neuritis and myelitis have often been diagnosed with "optic-spinal MS (OSMS)" in Asia, it was obscure whether "OSMS" is synonymous with NMO or includes both NMO and MS. Interferon β (IFNβ)-1a and -1b are used as the first-line disease-modifying therapy for MS. However, some neurologists have been reluctant to use IFNβ to treat patients with optic-spinal symptoms, because IFNβ therapy is not efficacious in NMO. To evaluate the therapeutic effect of IFNβ in patients with "genuine" OSMS, we retrospectively evaluated Japanese MS patients who fulfilled the following six criteria: 1) Relapsing-remitting MS with optic-spinal presentation alone (no brain symptoms), 2) With or without asymptomatic brain MRI lesions, 3) Oligoclonal IgG band-positive, 4) aquaporin-4 antibody seronegativity, 5) No myelitis extending longitudinally over ≥ 3 vertebral segments, and 6) Duration of IFNβ-1b therapy ≥ 2 years. Among 157 patients with MS, six (four women and two men, age 43.8 ± 8.5 years old) met all the criteria. Their Expanded Disability Status Scale scores were lowered (4.1 ± 2.4 → 3.1 ± 2.8) (P = 0.033) and annualized relapse rate was decreased (0.59 ± 0.34 → 0.13 ± 0.15) (P = 0.027) after IFNβ-1b therapy. These results suggest that IFNβ is therapeutically effective in inhibiting functional worsening and reducing relapse rate in "genuine" OSMS.
DOI	10.1620/tjem.223.211
PMID	21403431