TY - JOUR
T1 - Effect of Vitamin D on MS activity by disease-modifying therapy class
AU - Rotstein, Dalia L.
AU - Healy, Brian C.
AU - Malik, Muhammad T.
AU - Carruthers, Robert L.
AU - Musallam, Alexander J.
AU - Kivisakk, Pia
AU - Weiner, Howard L.
AU - Glanz, Bonnie
AU - Chitnis, Tanuja
N1 - Funding Information:
D.L.R. received a Fellowship Training Grant from the MS Society of Canada. R.L.C. received a Clinical Fellowship Training Grant from the National Multiple Sclerosis Society. The authors thank the patients participating in the CLIMB study for their contributions to MS research and to Mariann Polgar-Turcsanyi, MS, for her role in managing the Partners MS Center research database. This work was conducted with support from Harvard Catalyst/The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, NIH Award 8UL1TR000170-05, and financial contributions from Harvard University and its affiliated academic health care centers). The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic health care centers, or the NIH. Supported by the National Multiple Sclerosis Society RG-4256A4/2 (T.C.). The CLIMB study is funded in part by the Nancy Davis Foundation and Merck Serono S.A. This work was conducted with support from Harvard Catalyst/The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, NIH Award 8UL1TR000170-05, and financial contributions from Harvard University and its affiliated academic health care centers).
Publisher Copyright:
© 2015 American Academy of Neurology.
PY - 2015
Y1 - 2015
N2 - Objective: To determine whether vitamin D status predicts disease activity in patients with multiple sclerosis (MS) taking interferon-β (IFN), glatiramer acetate (GA), and fingolimod (FTY). Methods: Participants (n 5 324) with relapsing-remitting MS on IFN (96), GA (151), or FTY (77) were identified from the Comprehensive Longitudinal Investigation of MS at Brigham and Women's Hospital (CLIMB) Study at the Partners MS Center. FTY-treated participants were analyzed separately because of differences in selection. Serum vitamin 25(OH)D concentration was adjusted for season. We evaluated the relationship between 25(OH)D tertile and time to relapse or gadolinium-enhancing lesion using a Cox model adjusted for age, sex, and disease duration. Results: Higher 25(OH)D was associated with longer time to the combined endpoint in the overall IFN/GA cohort (p for trend 5 0.042; hazard ratio [HR] 5 0.77) and in the IFN subgroup (HRIFN 5 0.58; pIFN 5 0.012), but not in GA-treated participants (p 5 0.50; HR 5 0.89). For gadoliniumenhancing lesions alone, there was a significant association observed in GA and IFN subgroups, although the effect was more pronounced on IFN (HRGA 5 0.57; pGA 5 0.039 vs HRIFN 5 0.41; pIFN 5 0.022). No significant associations were found for relapses. For FTY, higher 25(OH)D was associated with longer survival for the combined endpoint (HRFTY 5 0.48; pFTY 5 0.016) and for relapses (HRFTY 5 0.50; pFTY 5 0.046), but not for gadolinium-enhancing lesions. Conclusions: Disease activity generally improved with higher 25(OH)D, but this study raises the question of effect modification by treatment class.
AB - Objective: To determine whether vitamin D status predicts disease activity in patients with multiple sclerosis (MS) taking interferon-β (IFN), glatiramer acetate (GA), and fingolimod (FTY). Methods: Participants (n 5 324) with relapsing-remitting MS on IFN (96), GA (151), or FTY (77) were identified from the Comprehensive Longitudinal Investigation of MS at Brigham and Women's Hospital (CLIMB) Study at the Partners MS Center. FTY-treated participants were analyzed separately because of differences in selection. Serum vitamin 25(OH)D concentration was adjusted for season. We evaluated the relationship between 25(OH)D tertile and time to relapse or gadolinium-enhancing lesion using a Cox model adjusted for age, sex, and disease duration. Results: Higher 25(OH)D was associated with longer time to the combined endpoint in the overall IFN/GA cohort (p for trend 5 0.042; hazard ratio [HR] 5 0.77) and in the IFN subgroup (HRIFN 5 0.58; pIFN 5 0.012), but not in GA-treated participants (p 5 0.50; HR 5 0.89). For gadoliniumenhancing lesions alone, there was a significant association observed in GA and IFN subgroups, although the effect was more pronounced on IFN (HRGA 5 0.57; pGA 5 0.039 vs HRIFN 5 0.41; pIFN 5 0.022). No significant associations were found for relapses. For FTY, higher 25(OH)D was associated with longer survival for the combined endpoint (HRFTY 5 0.48; pFTY 5 0.016) and for relapses (HRFTY 5 0.50; pFTY 5 0.046), but not for gadolinium-enhancing lesions. Conclusions: Disease activity generally improved with higher 25(OH)D, but this study raises the question of effect modification by treatment class.
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U2 - 10.1212/NXI.0000000000000167
DO - 10.1212/NXI.0000000000000167
M3 - Article
AN - SCOPUS:84952881399
SN - 2332-7812
VL - 2
JO - Neurology: Neuroimmunology and NeuroInflammation
JF - Neurology: Neuroimmunology and NeuroInflammation
IS - 6
M1 - e167
ER -