Every-other-day interferon beta-1b versus once-weekly interferon beta-1a for multiple sclerosis: results of a 2-year prospective randomized multicenter study (INCOMIN).
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Durelli L, Verdun E, Barbero P, et al. Every-other-day interferon beta-1b versus once-weekly interferon beta-1a for multiple sclerosis: results of a 2-year prospective randomized multicenter study (INCOMIN). Lancet 2002;359:1453–60. A trial was completed comparing the different interferon therapies for multiple sclerosis. The results indicate that interferon β-1b therapy every other day is more effective than weekly interferon β-1a. More patients who received interferon β-1b remained relapse free, and remained free from new T2 lesions on MRI. The differences between the two treatment groups were more significant during the second year.Keywords:
Interferon beta-1b
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Interferon beta in multiple sclerosisClinical cost effectiveness fals at thefirst hurdle Interferon beta-lb has now been granted a product licence in Britain.The department of health recently issued an executive letter providing "guidance" on the introduction of interferon beta:' purchasing authorities were asked "to initiate and continue prescribing of Beta-Interferon through hospitals."This is the first time that the NHS Executive has issued such a directive.Data from the Multiple Sclerosis Study Group show that interferon beta-lb significantly reduces the number of demyelinated plaques on magnetic resonance imaging in patients with multiple sclerosis and reduces relapse rates by up to 30%.2However, the studies showed no evidence of any reduction in the more clinically relevant endpoint-the progression of disability, which should be the goal of treatment.Patients treated with 8 MIU of interferon beta-lb avoided one in three relapses by the end of the second year and an average of 1.5 relapses over five years.4At a minimum cost of £10 000 per year, this -equates to £33 000 per relapse avoided.An average patient might experience 25-30 relapses in the course of his or her lifetime, so achieving a theoretical relapse free patient would cost up to i1m.In reality the drug will probably only delay rather than prevent disability, and it is therefore unlikely that economic benefits will include avoiding the need for social care for these patients.Most requests to health authorities for healthcare developments offer a far better health gain return.
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Because of the demonstration for the first time of a measurable effect on magnetic resonance imaging, the publication in 1993 of the results of the American trial of interferon beta-1b in multiple sclerosis constituted a turning point in the history of multiple sclerosis (MS) treatment. Although many questions subsist concerning its optimal use, it has become a standard in the treatment of relapsing remitting MS to which new and old drugs will have to be compared. It seemed therefore meaningful to review the results obtained with recombinant interferon beta-1b and the more recently developed interferon beta-1a, and to place them in the context of the other immunomodulatory treatments currently offered in MS.
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Durelli L, Verdun E, Barbero P, et al. Every-other-day interferon beta-1b versus once-weekly interferon beta-1a for multiple sclerosis: results of a 2-year prospective randomized multicenter study (INCOMIN). Lancet 2002;359:1453–60. A trial was completed comparing the different interferon therapies for multiple sclerosis. The results indicate that interferon β-1b therapy every other day is more effective than weekly interferon β-1a. More patients who received interferon β-1b remained relapse free, and remained free from new T2 lesions on MRI. The differences between the two treatment groups were more significant during the second year.
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INTRODUCTION: Beta-interferon treatment reduces number of relapses and probably slows down progression of remitting-relapsing multiple sclerosis (RRMS). The study objective was to compare functional status of RRMS patients on beta-interferon therapy. MATERIALS AND METHODS: Twenty patients (9 males and 11 females ; 35, 75+/-8, 25 years (mean+/-SD age) with RRMS were treated with beta-interferon at University Department of Neurology, Sestre milosrdnice University Hospital: 7 patients were treated with interferon beta 1b (9, 6 MIU every other day) and 13 patients were treated with interferon beta 1a (6 MIU 3 times weekly). Kurtzke's Expanded Disability Status Score (EDSS) was recorded at baseline and six months after initiation of beta-interferon therapy. RESULTS: In interferon beta 1a group average EDSS score before therapy was 3.00 and after six months of therapy it decreased to 2, 92. In interferon beta 1b group average EDSS was 3.07 before therapy and decreased to 3, 00 after six month of treatment The average EDSS score was slightly smaller after six months of beta-interferon treatment in both groups, but the difference did not reach statistical significance (p=0.17 in interferon beta 1a group ; p=0.36 in interferon beta 1b group). There was no statistically significant difference in EDSS score in all patients before and six months after interferon therapy (p=0.083). CONCLUSION: Results of this study, in small group of RRMS patients showed only slight benefit of beta-interferon therapy. However, further research involving larger number of patients is required to get additional information about functional status of multiple sclerosis patients treated with beta-interferon.
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Review of interferon beta-1b in the treatment of early and relapsing multiple sclerosis Damiano Paolicelli, Vita Direnzo, Maria TrojanoDepartment of Neurological and Psychiatric Sciences, University of Bari, Bari, ItalyAbstract: Multiple sclerosis (MS) is the most common autoimmune illness of the central nervous system. For many years the inflammatory manifestations of MS were treated using only corticosteroids. Since the 1990s the results of several clinical trials with immunomodulatory agents have changed the therapeutic approach to this disease. Interferon beta (IFNβ)-1b represents the pioneer of those therapies. There is growing evidence from clinical trials on relapsing-remitting MS and clinically isolated syndromes suggestive of MS that IFNβ-1b reduces the frequency and severity of relapses and the development of new and active brain lesions as assessed by magnetic resonance imaging. Long-term data suggest a persistent efficacy of IFNβ-1b on disease activity and a positive effect in slowing disability worsening. Furthermore a reduction of relapse rate and a slight positive effect on the progression were demonstrated when IFNβ-1b was administered to still-active secondary progressive MS. IFNβ-1b therapy is well tolerated and relatively free of long-term side effects. In spite of the emergence of new agents for the treatment of MS, IFNβ-1b still remains a first-line therapy with a fundamental role in all stages of the disease.Keywords: interferon beta-1b, relapsing-remitting multiple sclerosis, clinically isolated syndromes, efficacy, safety, neutralizing antibodies
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