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. 2015 Oct 29;2(6):e167.
doi: 10.1212/NXI.0000000000000167. eCollection 2015 Dec.

Effect of vitamin D on MS activity by disease-modifying therapy class

Dalia L Rotstein  1 , Brian C Healy  1 , Muhammad T Malik  1 , Robert L Carruthers  1 , Alexander J Musallam  1 , Pia Kivisakk  1 , Howard L Weiner  1 , Bonnie Glanz  1 , Tanuja Chitnis  1
Affiliations

Effect of vitamin D on MS activity by disease-modifying therapy class

Dalia L Rotstein et al. Neurol Neuroimmunol Neuroinflamm. .

Abstract

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 = 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 = 0.042; hazard ratio [HR] = 0.77) and in the IFN subgroup (HRIFN = 0.58; p IFN = 0.012), but not in GA-treated participants (p = 0.50; HR = 0.89). For gadolinium-enhancing lesions alone, there was a significant association observed in GA and IFN subgroups, although the effect was more pronounced on IFN (HRGA = 0.57; p GA = 0.039 vs HRIFN = 0.41; p IFN = 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 = 0.48; p FTY = 0.016) and for relapses (HRFTY = 0.50; p FTY = 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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Figures

Figure 1
Figure 1. Kaplan-Meier survival curves for the interferon/glatiramer acetate cohort
In each graph, bottom tertile: solid line; middle tertile: long dashed line; top tertile: short dashed line. (A) Time to first inflammatory event (relapse or gadolinium-enhancing lesion). (B) Time to first relapse. (C) Time to first gadolinium-enhancing lesion. (D) Time to first Expanded Disability Status Scale progression.
Figure 2
Figure 2. Kaplan-Meier survival curves for the fingolimod cohort
In each graph, bottom tertile: solid line; middle tertile: long dashed line; top tertile: short dashed line. (A) Time to first inflammatory event (relapse or gadolinium-enhancing lesion). (B) Time to first relapse. (C) Time to first gadolinium-enhancing lesion. (D) Time to first Expanded Disability Status Scale progression.
See this image and copyright information in PMC

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