T1 hypointense lesions in secondary progressive multiple sclerosis: effect of interferon beta-1b treatment

Recently, the clinical efficacy of interferon β-1b (IFNβ-1b) was demonstrated for secondary progressive (SP) multiple sclerosis in a European multicentre study. We evaluated the effect of IFNβ-1b treatment on the rate of development of hypointense T1 MRI lesions, a putative marker of axonal damage. Unenhanced T1-weighted images were obtained in a subgroup of 95 multiple sclerosis patients from five centres at 6-month intervals; this subgroup was similar to the total study population for all demographic, clinical and MRI parameters. An experienced observer blinded to the clinical data and treatment allocation measured volumes. The median baseline lesion load for hypointense T1 lesions was 5.1 cm3 for placebo-treated and 4.9 cm3 for IFNβ-1b-treated patients (P = 0.56). Placebo-treated patients showed an increase in T1 lesion load by a median of 14% per year (P = 0.0002 compared with baseline); this was reduced to 7.7% per year in the IFNβ-1b-treated patients (P = 0.003 versus placebo). In the IFNβ-1b arm there was a statistically significant correlation between absolute change in Expanded Disability Status Scale scores and T1 lesion load by month 36 (r = 0.38, P = 0.0015). In patients with SP multiple sclerosis, IFNβ-1b treatment reduces the development of hypointense T1 lesions, suggesting that reduced axonal damage in lesions may play a part in the beneficial effect that is observed clinicall