مقایسه اثرات هورمون‌های جنسی و اینترفرون در بروز حملات و شدت ناتوانی در بیماران مبتلا به مولتیپل اسکلروزیس عود کننده – بهبود یابنده(RRMS)

    Background & Aim: Multiple sclerosis(MS) is the most common demyelinative disease of central nervous system among young adults. The differences which are seen in clinical types, drug responses and geographical distribution of MS indicate the role of various factors in the etiology, pathogenesis and epidemiology of this disease. In addition, sexual prevalence and alteration of clinical manifestation during pregnancy may strongly suggest an important role for sex hormones. The aim of this study was to compare the impacts of interferon(IFN) and sex hormone as disease modifying agents in relapsing remitting MS(RRMS). Patients and Methods: This cohort study was conducted on 39 women which were supposed to have RRMS according to McDonald criteria. They were evaluated during a 32-month study period from January 2002 to August 2004 in four groups: 11 patients under both sex hormone and IFN(group A), 12 patients under IFN(group B), 6 patients under sex hormone(group C) and 10 patients who received neither sex hormone nor IFN(group D). The progression of disability which was determined using Kurtzke Expanded Disability Status Scale(EDSS) at the beginning and the end of study period, the number of relapses and demographic data were recorded and analyzed using SPSS v.11.5. For statistical analyses k.s, Paired T-Test, Kruskal-wallis, Mann whitney and correlation tests were used. Results: The mean age of patients was 28.36yr. (SD=8.36). The maximum and minimum number of relapses were seen in groups D(2.5 attacks, SD=1.17) and A(1.36 attacks, SD=0.50), respectively. Analysis showed significant statistical relation between number of attacks and sex hormone therapy(P=0.013). Also results demonstrated significant statistical difference in EDSS before and after treatment(P=0.000) and between EDSS changes and sex hormone therapy(P=0.019). IFN therapy influenced only the number of relapses(P=0.033) and did not show any relation with EDSS changes(P=0.32). Conclusion: The therapeutic role of sex hormones is still controversial. However, the results of our study indicate the role of sex hormone in women with RRMS and suggest that high concentration of sex hormones, especially estrogen(e.g during pregnancy), can decrease the number of relapses. Meanwhile, combination therapy with IFN and sex hormone may have a beneficial influence on decreasing the number of relapses and progression of disability.