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Inflammatory activity and vitamin D levels in an MS population treated with rituximab
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.ORCID iD: 0000-0002-9205-0771
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2019 (English)In: Multiple Sclerosis Journal, Experimental, Translational and Clinical, E-ISSN 2055-2173, Vol. 5, no 1, article id 2055217319826598Article in journal (Refereed) Published
Abstract [en]

Background: Most multiple sclerosis patients on disease-modifying treatment at Umeå University Hospital are treated with rituximab and the prevalence of vitamin D supplementation has increased over time. Follow-up studies of these off-label treatments are needed.

Objective: To study inflammatory activity and adverse effects in rituximab-treated multiple sclerosis patients, and associations with 25-hydroxy-vitamin D levels.

Methods: Retrospectively collected data on repeated estimates of relapses, disability, side effects, magnetic resonance imaging, laboratory measures including 25-hydroxy-vitamin D levels and self-perceived health.

Results: In 272 multiple sclerosis patients with a mean follow-up of 43 months, we identified seven possible relapses during active rituximab treatment. On magnetic resonance imaging examination, new T2 lesions were seen in 1.3% (10 out of 792 scans), and 0.25% (two out of 785 scans) showed contrast enhancement. Adjusted 25-hydroxy-vitamin D levels in samples drawn close to all magnetic resonance images with new T2 lesions were lower compared to the remainder (62 vs. 81 nmol/l; P = 0.030). Levels of 25-hydroxy-vitamin D were associated with self-perceived health (r = 0.18, P = 0.041, n = 130) and C-reactive protein (r = -0.13, P = 0.042) but not with the risk of side effects.

Conclusion: The inflammatory activity in this rituximab-treated multiple sclerosis population that increasingly used vitamin D supplementation was extremely low. Higher 25-hydroxy-vitamin D levels were associated with beneficial outcomes.

Place, publisher, year, edition, pages
2019. Vol. 5, no 1, article id 2055217319826598
Keywords [en]
MRI, Multiple sclerosis, disease-modifying therapies, rituximab, vitamin D
National Category
Neurology
Research subject
Neurology
Identifiers
URN: urn:nbn:se:umu:diva-167307DOI: 10.1177/2055217319826598PubMedID: 30800416OAI: oai:DiVA.org:umu-167307DiVA, id: diva2:1385829
Available from: 2020-01-15 Created: 2020-01-15 Last updated: 2020-01-17Bibliographically approved

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Granåsen, GabrielSalzer, JonatanSundström, Peter
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