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John N. Whitaker, MD; Beverly A. Layton, RN; Alfred A. Bartolucci, PhD; Galen W. Mitchell, MD; Khurram Bashir, MD; Jeanine Goodwin, BS; R. David Kachelhofer, BA, BS

Arch Neurol. 1999;56:687-691.

Objectives  To determine levels of urinary myelin basic protein–like material (MBPLM) in patients with multiple sclerosis (MS) openly treated with interferon beta-1b and to correlate these with clinical changes.

Background  Levels of urinary MBPLM correlate with the presence of the progressive phase of MS and with the disease burden detected on T₂-weighted, cranial magnetic resonance imaging. Measurement of urinary MBPLM level may be a feasible test for monitoring or predicting response to therapeutic measures.

Design and Methods  In a prospective study at one site, 166 patients with MS (131 with relapsing-remitting [RR] and 35 with secondary progressive [SP] disease) were treated for a minimum of 1 year and up to 3 years with interferon beta-1b and underwent assessment for neurologic disability (Expanded Disability Status Scale and Scripps Neurological Rating Scale) and change in disease subtype. Urine samples were obtained at 1219 of 1378 clinic visits, and urinary MBPLM level was determined and related to creatinine level to adjust for renal function.

Results  Statistical analysis using the general linear models procedure confirmed previous findings that the level of urinary MBPLM related to urinary creatinine level (MBPLM/creatinine) was higher (P<.001) in patients with SP than RR MS. Of the 131 patients with RR MS, SP disease developed in 13 during the observation period. Compared with those in the RR group, the RR to SP group had a higher level (P<.001) of urinary MBPLM and did not differ from the SP group.

Conclusions  The level of urinary MBPLM is higher in SP MS than RR MS but not in RR MS that converts to SP MS. Level of urinary MBPLM may permit the examination of treatment tested to prevent RR disease from becoming progressive.

From the Department of Neurology (Drs Whitaker, Mitchell, and Bashir, Mss Layton and Goodwin, and Mr Kachelhofer), the Center for Neuroimmunology (Drs Whitaker and Bashir), School of Medicine, and the Department of Biostatistics (Dr Bartolucci), School of Public Health, University of Alabama at Birmingham; and Neurology and Research Services, Birmingham Veterans Medical Center, Birmingham, Ala (Dr Whitaker).

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