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Original Investigation |

Interleukin 17F Level and Interferon Beta Response in Patients With Multiple Sclerosis

Hans-Peter Hartung, MD1; Lawrence Steinman, MD4; Douglas S. Goodin, MD5; Giancarlo Comi, MD6; Stuart Cook, MD7; Massimo Filippi, MD6; Paul O’Connor, MD9; Douglas R. Jeffery, MD10; Ludwig Kappos, MD11; Robert Axtell, MS, PhD4; Volker Knappertz, MD1,12; Timon Bogumil, MD8; Susanne Schwenke, PhD2; Ed Croze, PhD8; Rupert Sandbrink, MD, PhD1,2; Christopher Pohl, MD2,3
[+] Author Affiliations
1Department of Neurology, Heinrich-Heine-Universität, Düsseldorf, Germany
2Bayer Pharma, Berlin, Germany
3University Hospital of Bonn, Bonn, Germany
4Department of Neurology, Stanford University, Stanford, California
5University of California, San Francisco
6University “Vita-Salute” San Raffaele, Milan, Italy
7New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark
8Bayer HealthCare, Montville, New Jersey
9Department of Neurology, St Michael’s Hospital, Toronto, Ontario, Canada
10Multiple Sclerosis Center, Advance Neurology and Pain, Cornerstone Health Care, Advance, North Carolina
11University Hospital, Basel, Switzerland
12MedImmune, Gaithersburg, Maryland
JAMA Neurol. 2013;70(8):1017-1021. doi:10.1001/jamaneurol.2013.192.
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Importance  High serum levels of interleukin 17F (IL-17F) at baseline have been associated with suboptimal response to interferon beta in patients with relapsing-remitting multiple sclerosis.

Objective  To further investigate the role of IL-17F in predicting treatment response to interferon beta-1b in patients with relapsing-remitting multiple sclerosis using the Singulex Erenna IL-17F immunoassay.

Design, Setting, and Patients  Serum samples were analyzed from 239 randomly selected patients treated with interferon beta-1b, 250 μg, for at least 2 years in the Betaferon Efficacy Yielding Outcomes of a New Dose Study.

Exposure  Treatment with interferon beta-1b, 250 μg, for at least 2 years.

Main Outcome Measures  Levels of IL-17F at baseline and month 6 as well as the difference between the IL-17F levels at month 6 and baseline were compared between the following: (1) patients with less disease activity vs more disease activity; (2) patients with no disease activity vs some disease activity; and (3) responders vs nonresponders.

Results  Levels of IL-17F measured at baseline and month 6 did not correlate with lack of response to treatment after 2 years using clinical and magnetic resonance imaging criteria. Relapses and new lesions on magnetic resonance imaging were not associated with pretreatment serum IL-17F levels. When patients with neutralizing antibodies were excluded, the results did not change. All patients with levels of IL-17F greater than 200 pg/mL were associated with poor response with some clinical or radiological activity.

Conclusions and Relevance  An increase of IL-17F before and early after treatment with interferon beta-1b was not associated with poor response. These data do not support the value of IL-17F as a treatment response indicator for therapy of patients with multiple sclerosis with interferon beta, although high levels of IL-17F greater than 200 pg/mL may predict nonresponsiveness.

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