Long-term subcutaneous interferon beta-1a therapy in patients with relapsing-remitting MS

Abstract

Despite the limitations inherent in any long-term study (for example, potential differences between returning and nonreturning patients), these results indicate that patients with relapsing-remitting multiple sclerosis can experience sustained benefit over many years from early interferon beta-1a subcutaneous therapy three times weekly compared with patients whose treatment is delayed. This effect was more apparent in the patients receiving the higher dose.

Long-term effect of early treatment with interferon beta-1b after a first clinical event suggestive of multiple sclerosis: 5-year active treatment extension of the phase 3 BENEFIT trial

“…Prospectively planned long-term studies on the diff erence between early and delayed intervention in chronic diseases are rare. Many published long-term extensions of clinical trials (one in clinically isolated syndromes [table 7], 22 two in relapsing-remitting multiple sclerosis 23,24 ) have severe methodological restrictions-eg, non-prospective design, high and possibly selective dropout rates, unblinded assessments, and poor monitoring-that limit their interpretation. 25 In designing and doing the long-term follow-up of the present BENEFIT study, major eff orts were made to address these issues by strictly applying the intention-to-treat principle, keeping the blinding for the original treatment allocations, retaining the same standards of assessment, and by prospectively planning the statistical analyses.…”

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—establishing disease prognosis and monitoring patients

“…58 Statements and recommendations ■ T2 weighted and contrast enhanced T1 weighted brain MRI are the modalities of choice for MS disease monitoring, revealing acute and active inflammation, and clinically silent disease progression 24 Early prediction Some evidence suggests that certain baseline demo graphic variables (for example, age at treatment initi ation), clinical factors (including disease duration at treatment initiation and pretreatment relapse rate) and MRI measures related to disease activity (such as base line lesion load) can help to indicate which patients will benefit most from a first line DMD, and who will have a poor response. 66,[71][72][73][74] However, the relevant studies mainly analysed cohorts receiving different IFN β formulations, produced preliminary or inconsistent results, and have failed to satisfactorily predict treatment response in clinical practice. 70 Other MRI derived metrics-such as global or regional brain volume, or the number of spinal cord lesions-have shown value for predicting relapses or disability progression, 35-37,39,75-77 but have not been specifically analysed for treatment response predictions.…”

Adherence to First-Line Disease-Modifying Therapy for Multiple Sclerosis in Kuwait

“…9,38,39 Most adverse events tend to diminish in frequency and severity with increased time on treatment. 40,41 Educating the patient on appropriate injection techniques, the availability of new injection devices, the use of escalating dosages, and concomitant administration of nonsteroidal anti-inflammatory drugs (NSAIDs) can minimize these adverse events and thus increase adherence. 32,[42][43][44][45][46][47] Physician-documented disease progression was another factor in nonadherence in our study, with 17.7% of nonadherent patients discontinuing their DMTs upon being told that the disease had entered a progressive phase and the likelihood of ongoing beneficial effects was low.…”