http://jnnp.bmj.com/cgi/content/short/jnnp.2008.171090v1?q=w_jnnp_ahead_tab
Layperson's summary: Treatment with glatiramer acetate or the interferon may limit the number of new black holes that became permanent; i.e., reduce progression of brain atrophy, and the interferon seemed to be slightly better at it. There is no control (i.e., untreated) group for comparison of how well the ************** worked vs. no treatment at all.
New acute and chronic black holes in multiple sclerosis patients randomized to interferon beta-1b or glatiramer acetate
Diego Cadavid 1*, Jojy Cheriyan 1, Joan Skurnick 1, John A Lincoln 1, Leo J Wolansky 1 and Stuart D Cook 1
1 UMDNJ-New Jersey Medical School, United States
To whom correspondence should be addressed. E-mail: ***@****.
Abstract
Background: Hypointense lesions on T1 weighted MRI, referred to as black holes (BH), are a marker of demyelination/axonal loss in multiple sclerosis (MS). There is some evidence that glatiramer acetate (GA) may decrease the conversion of new brain lesions to BH.
Methods: We used monthly 3 Tesla brain MRI scans for up to 2 years to study the development and evolution of new BH in 75 MS patients randomized to GA or Interferon {beta}-1b (IFNb1b) in the BECOME study.
Findings: Of 1,224 newly enhancing lesions (NEL) appearing at baseline through 24 months in 61 patients, 767 (62•7%) showed an acute BH( ABH). The majority of ABH were transient and of similar duration by treatment group. Of 571 ABH in which MRI follow-up scans were available for ≥1 year, 103 (18.8%) were still visible ≥12 months after onset and were considered chronic BH (CBH). Only 12.1% of the 849 NEL with MRI follow-up ≥1 year converted to CBH, 9.8% with IFN{beta}1b and 15.2•% with GA (p=0•02). The conversion from ABH to CBH was also lower with IFN{beta}1b (15.2%) than with GA (21•4%), of borderline significance (p=0.06). The majority of patients who developed NEL did not develop CBH; however, about a quarter had conversion rates from ABH to CBH greater than 20%.
Interpretation: Only a minority of new brain lesions in MS patients treated with GA or IFN{beta}1b convert to CBH.