Prognostic value of soluble tumor necrosis factor receptors 1 and 2 in multiple sclerosis patients treated with interferon beta-1b

The objective of this study was to investigate the effect of interferon (IF N) beta-lb on the serum levels of soluble tumor necrosis factor receptor 1 (sTNF-R1) and sTNF-R2 in patients with multiple sclerosis (MS) in correlati on with clinical and magnetic resonance image (MRI) activity. Serum samples were obtained every 3 months from 24 patients treated with 8 x 10(6) U of IFN beta-lb every other day (treatment group) and from 21 patients without any immunomodulatory therapy (control group) over a 15-month observation pe riod. The cytokine receptor levels were assessed by ELISA. Cranial MRI was performed every 6 months to determine the burden of disease. In the treatme nt group, the MRI responders had significantly larger mean values for the a rea under the concentration-time curve of sTNF-R1 (p = 0.04) and sTNF-R2 (p = 0.01) when compared to the MRI nonresponders during the 15-month observa tion period. With regard to an increase in sTNF-R1 and -2 of more than 20% during the first 3 months of treatment, we observed a sensitivity of 33 and 58%, respectively, a specificity of 90 and 60%, respectively, and a positi ve predictive value of 80 and 64%, respectively, for MRI response during th e 15-month observation period. A decrease in sTNF-R1 and -2 of more than 20 % during the first 3 months of treatment had a sensitivity of 40 and 20%, r espectively, a specificity of 100 and 100%, respectively, and a positive pr edictive value of 100 and 100%, respectively, for further MRI nonresponse ( during the 15-month observation period). The present data suggest that asse ssment of sTNF-Rs may contribute to the identification of subgroups of pati ents who are likely to respond better than others to treatment with IFN bet a-lb. This could help to establish a cost-effective prescription pattern fo r this expensive treatment, which is of importance for the future managemen t of patients with MS. Copyright (C) 2001 S. Karger AG, Basel.