Comparative efficacy of interferon β versus glatiramer acetate for relapsing-remitting multiple sclerosis

Abstract

Interferon β (INFβ) and glatiramer acetate (GA) are widely used in patients with relapsing-remitting multiple sclerosis (RRMS). However, it is still unclear whether they have different efficacy. We performed a systematic search of head-to-head trials for gaining objective reliable data to compare the two drugs, using the Cochrane Collaboration methodology. We identified five randomised-controlled trials (RCTs) (2858 participants) comparing directly INFβ versus GA in RRMS. All studies were at high risk for attrition bias. Both therapies showed similar efficacy at 24 months, considering clinical (patients with relapse or progression) and one MRI activity (enhancing lesions) measure. At 3 years, evidence from a single study showed that the relapse rate was higher in the INFβ group than in the GA group (risk ratio 1.40, 95% CI 1.13 to 1.74, p 0.002). However, the average reduction in T2-weighted and T1-weighted lesion volume was significantly greater in the INFβ group than in the GA group (mean difference (MD) -0.58, 95% CI -0.99 to -0.18, p 0.004, and MD -0.20, 95% CI -0.33 to -0.07, p 0.003, respectively). The number of participants who dropped out of the studies because of adverse events was similar in the two groups. These data support clinicians in the use of these therapies, based on their similar safety and efficacy in the prevention of disease activity, although the different effect on MRI measures and the different tolerability might have a role in the therapeutic choice at the individual level.

Disease-modifying therapies for multiple sclerosis

“…A systematic review (five randomised controlled trials, 2858 participants) comparing interferon beta preparations and glatiramer acetate found a similar effect on relapses and disability progression, although secondary MRI endpoints favoured interferon beta 33. In separate phase III randomised controlled trials, interferon beta had similar efficacy to teriflunomide, and was less effective than fingolimod, alemtuzumab, and ocrelizumab 18192021222326…”

The heritage of glatiramer acetate and its use in multiple sclerosis

“…A systematic review summarising data from five randomised studies comparing IFN-β with GA in patients with RRMS confirmed a similar efficacy after 2 years of treatment [62].…”

Disease‐modifying drugs for multiple sclerosis in Japan: A focus on the 2017 Japanese guidelines and the 2018 supplement

“…2 When a prescribed DMD is judged ineffective, it should be either substituted with another first-line drug or switched with a second-line (fingolimod or natalizumab for anti-JC virus antibody-negative patients) or third-line (natalizumab for anti-JC virus antibody-positive patients) drug. 2,4 While switching between first-line drug therapies, a Cochrane Collaboration methodology-based study reported reliable data comparing IFNb and GA, and concluded the two therapies do not seem to differ in terms of clinical efficacy and safety, although IFN was found to limit the increase of MRI lesion burden more than GA. 35 With similar safety and efficacy in the prevention of disease activity, clinicians can select a therapy preferable for their patient based on MRI measures and tolerability differences. 2,4 While switching between first-line drug therapies, a Cochrane Collaboration methodology-based study reported reliable data comparing IFNb and GA, and concluded the two therapies do not seem to differ in terms of clinical efficacy and safety, although IFN was found to limit the increase of MRI lesion burden more than GA. 35 With similar safety and efficacy in the prevention of disease activity, clinicians can select a therapy preferable for their patient based on MRI measures and tolerability differences.…”

“…2,4 This stepwise use of DMD, wherein the safety risk increases with stronger potency for suppression of MS disease activity, is termed as escalation therapy. 35 Highly active disease in MS patients is defined as more than two clinical relapses within the previous 12 months, two separate MRI scans showing more than a few Gd-enhancing lesions and/or new or enlarging T2 lesions, and rapid progression of the Expanded Disability Status Scale score. 35 Highly active disease in MS patients is defined as more than two clinical relapses within the previous 12 months, two separate MRI scans showing more than a few Gd-enhancing lesions and/or new or enlarging T2 lesions, and rapid progression of the Expanded Disability Status Scale score.…”