Health-related quality of life in patients with relapsing-remitting multiple sclerosis treated with subcutaneous interferon ß-1a in Iran.

PURPOSE: Multiple sclerosis (MS) requires long-term therapy and can affect many aspects of a patient's life, including quality of life. MS patients score lower on health-related quality of life (HRQoL) measures. The efficacy of subcutaneous interferon (IFN) ß-1a has been extensively evaluated by using objective measures but its impact on HRQoL is currently unclear. In this observational study, we evaluated HRQoL of Iranian patients with relapsing-remitting MS (RRMS) treated with IFN ß-1a by using short-form 36 (SF-36) and multiple sclerosis international quality of life (MusiQoL) questionnaires. METHODS: Four hundred recruited RRMS patients were treated with human serum album free IFN ß-1a for 1 year. Patients were required to fill in SF-36 and MusiQoL questionnaires at the first visit and at each follow-up visit. Expanded disability status scale (EDSS) evaluation was performed at baseline and at each visit. Comparisons in HRQoL between visits were calculated using Cohen's d effect size. The relationship between change in EDSS score and the score of each questionnaire was calculated using Pearson correlation coefficients. RESULTS: Three-hundred and eighty three completed the study. Two-hundred and thirty nine were female. Mean (SD) age was 28.75 (±5.49). After 1 year, overall MusiQoL Index score effect size was -0.16 and SF-36 physical component and mental component showed overall effect sizes of -0.28 and -0.53, respectively. Mean (range) EDSS change was 1 (1-4). Three-hundred and seventy four were clinically stable with mean (range) EDSS change of 0.1 (-2-0.5). Increase in EDSS was linked to a decrease in both MusiQoL and SF-36. CONCLUSION: We found that, HRQoL did not change significantly over the first year of therapy. Furthermore, decreases in HRQoL were inversely correlated with increases in EDSS score.

Serum and CSF vitamin A concentrations in idiopathic intracranial hypertension.

BACKGROUND: Elevated serum retinol, CSF retinol, and serum retinol binding protein (RBP) levels have been found in some patients with idiopathic intracranial hypertension (IIH), but serum and CSF retinol levels have not been studied in matched serum and CSF samples in patients with IIH. OBJECTIVE: To determine whether serum and CSF vitamin A concentrations are associated with IIH. METHODS: The serum and CSF retinol concentrations were prospectively assessed in 20 patients with IIH and 20 control subjects. RESULTS: CSF retinol concentration was higher in the patient group (median 575.91 nM) vs the control group (median 63.35 nM) (p < 0.05). There was no difference in serum retinol levels between control subjects (median 896.51 nM) and patients (median 1,002.62 nM) (p = 0.10). There was an association between higher vitamin A levels (> 250 nM) and IIH (p = 0.039). There was a correlation between CSF and serum retinol levels in patients (r = 0.82) and control subjects (r = 0.66). CONCLUSION: Elevated CSF retinol concentration is associated with idiopathic intracranial hypertension (IIH), but serum retinol level is not associated with IIH.