Article

Enhanced benefit of increasing interferon beta-1a dose and frequency in relapsing multiple sclerosis - The EVIDENCE study

University of Cambridge, Cambridge, England, United Kingdom
JAMA Neurology (Impact Factor: 7.01). 06/2005; 62(5):785-92. DOI: 10.1001/archneur.62.5.785
Source: PubMed

ABSTRACT The EVIDENCE (Evidence of Interferon Dose-Response: European North American Comparative Efficacy) Study demonstrated that patients with multiple sclerosis (MS) who initiate interferon beta-1a therapy with 44 microg 3 times weekly (TIW) were less likely to have a relapse or activity on magnetic resonance imaging (MRI) compared with those who initiate therapy at a dosage of 30 microg 1 time weekly (QW).
To determine the effect of changing the dosage from 30 microg QW to 44 microg TIW in this extension of the EVIDENCE Study.
Patients with relapsing MS originally randomized to interferon beta-1a, 30 microg QW, during the comparative phase of the study changed to 44 microg TIW, whereas patients originally randomized to 44 microg TIW continued that regimen. Patients were followed up, on average, for an additional 32 weeks.
The within-patient pretransition to post-transition change in relapse rate.
At the transition visit, 223 (73%) of 306 patients receiving 30 microg QW converted to 44 microg TIW, and 272 (91%) of 299 receiving 44-microg TIW continued the same therapy. The post-transition annualized relapse rate decreased from 0.64 to 0.32 for patients increasing the dose (P<.001) and from 0.46 to 0.34 for patients continuing 44-microg TIW (P = .03). The change was greater in those increasing dose and frequency (P = .047). Patients converting to the 44-mug TIW regimen had fewer active lesions on T2-weighted MRI compared with before the transition (P = .02), whereas those continuing the 44-microg TIW regimen had no significant change in T2 active lesions. Patients who converted to high-dose/high-frequency interferon beta-1a therapy had increased rates of adverse events and treatment terminations consistent with the initiation of high-dose subcutaneous interferon therapy.
Patients receiving interferon beta-1a improved on clinical and MRI disease measures when they changed from 30 microg QW to 44 microg TIW.

0 Bookmarks
 · 
73 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Multiple sclerosis (MS) is an inflammatory demyelinating disease of the CNS. Evidence suggests that MS should be treated as early as possible in order to maximize the benefit of treatment. Areas covered: This review details current understanding about the treatment of relapsing-remitting MS (RRMS). The pharmacological and clinical data on the use of subcutaneous (s.c.) interferon β-1a (IFN-β-1a) as a therapeutic option for RRMS are covered, with a focus on the importance of treating patients with MS as early as possible in the course of the disease, in order to delay permanent axonal damage that is responsible for the signs and symptoms of disease progression. Expert opinion: There is a wealth of data on the treatment of RRMS with s.c. IFN-β-1a indicating that patients treated during the early inflammatory stages of the disease have significantly improved short-term outcomes compared with patients who commence treatment late. It remains to be determined whether the short-term effects of early treatment will translate into long-lasting benefits, although it is hoped that ongoing research will help to answer this question.
    Expert Opinion on Biological Therapy 06/2014; DOI:10.1517/14712598.2014.924496 · 3.65 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Interferon β-1b (IFNB-1b, Betaferon®) ist die erste verfügbare immunmodulierende Therapie zur Behandlung der schubförmigen Multiplen Sklerose (MS), die in einer klinischen Studie eine Überlegenheit gegenüber Placebo zeigte. Frühere Studien deuteten darauf hin, dass die klinische Wirksamkeit von IFNB-1b eine Dosisabhängigkeit aufweist, dennoch gab es bis vor kurzem keine verlässlichen Daten dazu, in welcher Dosierung ein maximaler therapeutischer Effekt zu erzielen ist. Zudem fehlten klinische Studien, die IFNB-1b direkt mit Glatirameracetat verglichen, einer alternativen Erstlinientherapie der MS.Beides wurde nun erstmalig in der kürzlich publizierten BEYOND-Studie untersucht. In dieser Übersichtsarbeit sollen die Ergebnisse dieser aktuellen Studie dargestellt und diskutiert werden.
    Der Nervenarzt 01/2010; 81(12). DOI:10.1007/s00115-010-3017-5 · 0.86 Impact Factor
  • Source