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Abstract

Background: Findings from a small clinical study suggested that statins may counteract the therapeutic effects of interferon beta (IFNβ) in patients with relapsing-remitting multiple sclerosis (RRMS).
Methods: We conducted a post hoc analysis of data from the Safety and Efficacy of Natalizumab in Combination With IFNβ-1a in Patients With Relapsing-Remitting Multiple Sclerosis (SENTINEL) study to determine the effects of statins on efficacy of IFNβ. SENTINEL was a prospective trial of patients with RRMS treated with natalizumab (Tysabri®, Biogen Idec, Inc., Cambridge, MA) plus IM IFNβ-1a (Avonex®, Biogen Idec, Inc.) 30 μg compared with placebo plus IM IFNβ-1a 30 μg. Clinical and MRI outcomes in patients treated with IM IFNβ-1a only (no-statins group, n = 542) were compared with those of patients taking IM IFNβ-1a and statins at doses used to treat hyperlipidemia (statins group, n = 40).
Results: No significant differences were observed between treatment groups in adjusted annualized relapse rate (p = 0.937), disability progression (p = 0.438), number of gadolinium-enhancing lesions (p = 0.604), or number of new or enlarging T2-hyperintense lesions (p = 0.802) at 2 years. More patients in the statins group reported fatigue, extremity pain, muscle aches, and increases in hepatic transaminases compared with patients in the no-statins group. Statin treatment had no ex vivo or in vitro effect on induction of IFN-stimulated genes.
Conclusions: Statin therapy does not appear to affect clinical effects of IM interferon beta-1a in patients with relapsing-remitting multiple sclerosis or the primary molecular response to interferon beta treatment.

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Information & Authors

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Published In

Neurology®
Volume 72Number 23June 9, 2009
Pages: 1989-1993
PubMed: 19506220

Publication History

Published online: June 8, 2009
Published in print: June 9, 2009

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Authors

Affiliations & Disclosures

R. A. Rudick, MD
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.
A. Pace, ScD
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.
M.R.S. Rani, PhD
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.
R. Hyde, PhD
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.
M. Panzara, MD
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.
S. Appachi, BS
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.
J. Shrock, BA
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.
S. L. Maurer, PharmD
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.
P. A. Calabresi, MD
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.
C. Confavreux, MD
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.
S. L. Galetta, MD
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.
F. D. Lublin, MD
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.
E. -W. Radue, MD
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.
R. M. Ransohoff, MD
From the Mellen Center for Multiple Sclerosis Treatment and Research (R.A.R., R.M.R.) and Neuroinflammation Research Center, Lerner Research Institute (M.R.S.R., S.A., J.S., R.M.R.), Cleveland Clinic, Cleveland, OH; Biogen Idec, Inc. (A.P., R.H., M.P.), Cambridge, MA; Scientific Connexions (S.L.M.), Newtown, PA; Johns Hopkins Multiple Sclerosis Center (P.A.C.), Baltimore, MD; Hôpital Neurologique (C.C.), Lyon, France; University of Pennsylvania School of Medicine (S.L.G.), Philadelphia; Mt. Sinai School of Medicine (F.D.L.), New York, NY; and University Hospital Basel (E.-W.R.), Basel, Switzerland.

Notes

Address correspondence and reprint requests to Dr. Richard A. Rudick, Mellen Center for Treatment and Research in Multiple Sclerosis, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195 [email protected]

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