Interferon-? and serum 25-hydroxyvitamin D interact to modulate relapse risk in MS.

Neurology. 2012 Jul 17;79(3):254-60. Epub 2012 Jun 13.
Stewart N, Simpson S Jr, van der Mei I, Ponsonby AL, Blizzard L, Dwyer T, Pittas F, Eyles D, Ko P, Taylor BV bruce.taylor at utas.edu.au

OBJECTIVE: To determine whether interferon-? (IFN-?) medication use is associated with vitamin D levels and whether the two interact in exerting effects on relapse risk.

METHODS: In a prospective cohort of 178 persons with clinically definite multiple sclerosis (MS) living in southern Tasmania in 2002-2005, serum 25-hydroxyvitamin D [25(OH)D] was measured biannually, with assessment by questionnaire for relevant factors, including IFN-? treatment.

RESULTS: Subjects reporting IFN-? use had significantly higher mean 25(OH)D than persons who did not (p < 0.001). This was mediated by an interaction between personal sun exposure and IFN-?, with treated persons realizing nearly three times 25(OH)D per hour of sun exposure of persons not on therapy. The association between 25(OH)D and 1,25-dihydroxyvitamin D did not differ by IFN-? therapy (p = 0.82).

25(OH)D was associated with a reduced relapse risk only among persons on IFN-? (p < 0.001).

Importantly, IFN-? was only protective against relapse among persons with higher 25(OH)D (hazard ratio [HR] 0.58 [95% confidence interval (CI) 0.35-0.98]), while among 25(OH)D-insufficient persons, IFN-? increased relapse risk (HR 2.01 [95% CI 1.22-3.32]).

CONCLUSION: In this study, we found that IFN-? therapy is associated with greater production of vitamin D from sun exposure, suggesting part of the therapeutic effects of IFN-? on relapse in MS may be through modulation of vitamin D metabolism. These findings suggest persons being treated with IFN-? should have vitamin D status monitored and maintained in the sufficiency range. Classification of evidence: This study provided Class III evidence that IFN-? is associated with reduced risk of relapse, and this effect may be modified by a positive effect of IFN-? on serum 25(OH)D levels.

PMID: 22700816
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See also VitaminDWiki

• Overview MS and vitamin D
• Neurology J. had 4 items on Multiple Sclerosis and Vitamin D – review by MS Soc Aug 2012
  Clinical trials for MS and Vitamin D 17 as of May 2012
  Vitamin D being used for MS more than any other disease
  3 books with sections on MS and vitamin D
  Vitamin D found to be far better than FDA drug for MS
  Many MS websites are very pro vitamin D
  People at risk of having low vitamin D (elderly, women, blacks,...) have greater incidence of MS
• Vitamin D reduces multiple sclerosis relapses, but not with interferon treatment – June 2012
  Perhaps because the interferon had already increased the vitamin D levels
• All items in category MS and vitamin D 412 items

See also web

• Meta-analysis of the efficacy and tolerability of interferon-? in multiple sclerosis Oct 2010
  has been approved in >80 countries worldwide
• Interferon not reduce MS outcomes July 2012 Health Central Comment JAMA publication
• Lancet 1997
  Interferon Beta injections cost about $20,000 per year

Hmm: Vitamin D compared to interferon-?

• Much better at decreasing frequency and intensity of MS relapses
• Prevents MS
• No side effects (vs MS drugs)
• 2000X lower cost than interferon-?
• However, interferon-? is supported by profits in big pharma and income to the medical profession
  Suspect, for example, that doctors get 10X to 100X more for monitoring interferon treatment than for monitoring Vitamin D treatment