Chronic motor neuropathies: response to interferon-β1a after failure of conventional therapies
- aDepartment of Neurology, University Hospital Rotterdam, Dr Molewaterplein, Rotterdam, The Netherlands, bDepartment of Statistics, Daniel den Hoed Cancer Centre, University Hospital Rotterdam, Groene Hilledijk, Rotterdam, The Netherlands
- Dr I SJ Martina, Department of Neurology, University Hospital Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. Telephone 0031 10 4639222; fax 0031 10 4633208.
- Received 10 April 1998
- Revised 24 July 1998
- Accepted 11 September 1998
Abstract
OBJECTIVES The effect of interferon-β1a (INF-β1a; Rebif®) was studied in patients with chronic motor neuropathies not improving after conventional treatments such as immunoglobulins, steroids, cyclophosphamide or plasma exchange.
METHODS A prospective open study was performed with a duration of 6–12 months. Three patients with a multifocal motor neuropathy and one patient with a pure motor form of chronic inflammatory demyelinating polyneuropathy were enrolled. Three patients had anti-GM1 antibodies. Treatment consisted of subcutaneous injections of IBF-β1a (6 MIU), three times a week. Primary outcome was assessed at the level of disability using the nine hole peg test, the 10 metres walking test, and the modified Rankin scale. Secondary outcome was measured at the impairment level using a slightly modified MRC sumscore.
RESULTS All patients showed a significant improvement on the modified MRC sumscore. The time required to walk 10 metres and to fulfil the nine hole peg test was also significantly reduced in the first 3 months in most patients. However, the translation of these results to functional improvement on the modified Rankin was only seen in two patients. There were no severe adverse events. Motor conduction blocks were partially restored in one patient only. Anti-GM1 antibody titres did not change.
CONCLUSION These findings indicate that severely affected patients with chronic motor neuropathies not responding to conventional therapies may improve when treated with INF-β1a. From this study it is suggested that INF-β1a should be administered in patients with chronic motor neuropathies for a period of up to 3 months before deciding to cease treatment. A controlled trial is necessary to confirm these findings.
