A recent review suggests that there is an additive benefit when vitamin D and interferon beta 1b (IFNβ-1b) are combined to treat patients with multiple sclerosis (MS). Findings from the study are published in European Neurological Review

Growing evidence shows an association between vitamin D levels and the course of MS. Previous studies have established that the risk of MS is higher in patients with low vitamin D intake or low serum 25-hydroxyvitamin D (25[OH]D) levels. Study authors set out to review the relationship between vitamin D and MS disease activity, and the effects of vitamin D and IFNβ-1b in MS patients from the BENEFIT and the BEYOND studies.

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The BENEFIT (BEtaferon/ Betaseron in Newly Emerging multiple sclerosis For Initial Treatment) study demonstrated that average serum 25(OH)D levels were strong predictors of MS disease activity and progression. For patients with 25(OH)D levels ≥50nmol/L starting IFNβ-1b, the probability of clinically definite MS and magnetic resonance imaging (MRI) activity was lower. Also, a positive effect on relapse rate, occurrence of new active MRI lesions, and disease progression was seen with a 50nmol/L increase in 25(OH)D levels. 

The BEYOND (Betaferon/Betaseron Efficacy Yielding Outcomes of a New Dose in multiple sclerosis) study, which evaluated relapsing-remitting (RR) MS patients, demonstrated that 25(OH)D levels were inversely tied to MRI markers of MS activity. Findings from this study suggest a possible benefit in managing vitamin D levels in early MS patients treated with IFNβ-1b. A cumulative number of risk alleles predict lower 25(OH)D levels in the clinically isolated syndrome (CIS) and RRMS patients.

Other studies have suggested that modulating vitamin D metabolism could influence the IFNβ-1b therapeutic effects on relapse. In general, treatment with both vitamin D and IFNβ-1b may be beneficial for clinical and MRI measures. Further research is needed to evaluate this relationship. 

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