Urinary myelin basic protein-like material in patients with multiple sclerosis during interferon beta-lb treatment

Objectives: To determine levels of urinary myelin basic protein-like materi al (MBPLM) in patients with multiple sclerosis (MS) openly treated with int erferon beta-1b and to correlate these with clinical changes. Background: Levels of urinary MBPLM correlate with the presence of the prog ressive phase of MS and with the disease burden detected on T-2-weighted, c ranial magnetic resonance imaging. Measurement of urinary MBPLM level may b e a feasible test for monitoring or predicting response to therapeutic meas ures. Design and Methods: In a prospective study at one site, 166 patients with M S (131 with relapsing-remitting [RR] and 35 with secondary progressive [SP] disease) were treated for a minimum of 1 year and up to 3 years with inter feron beta-1b and underwent assessment for neurologic disability (Expanded Disability Status Scale and Scripps Neurological Rating Scale) and change i n disease subtype. Urine samples were obtained at 1219 of 1378 clinic visit s, and urinary MBPLM level was determined and related to creatinine level t o adjust for renal function. Results: Statistical analysis using the general linear models procedure con firmed previous findings that the level of urinary MBPLM related to urinary creatinine level (MBPLM/creatinine) was higher (P<.001) in patients with S P than RR MS. Of the 131 patients with RR MS, SP disease developed in 13 du ring the observation period. Compared with those in the RR group, the RR to SP group had a higher level (P<.001) of urinary MBPLM and did not differ f rom the SP group. Conclusions: The level of urinary MBPLM is higher in SP MS than RR MS but n ot in RR MS that converts to SP MS. Level of urinary MBPLM may permit the e xamination of treatment tested to prevent RR disease from becoming progress ive.