Highlights
- •Long-term disease evolution is marginally different across Interferon-β formulation.
- •Reaching of EDSS 4.0 is not-significantly higher for Interferon-β1b (20%), and Interferon-β1a 30 mcg (30%), compared with Interferon-β1a 44 mcg.
- •SP conversion is 100% higher for Interferon-β1b, and not-significantly higher (80%) for Interferon-β1a 30 mcg, compared with Interferon-β1a 44 mcg.
- •Formulation, frequency of administration and dose of Interferon-β can affect the long-term clinical evolution of relapsing-remitting multiple sclerosis.
Abstract
Background
Interferon-β has been approved for the treatment of relapsing-remitting (RR) multiple
sclerosis (MS), whereas its efficacy in preventing long-term disability and conversion
to secondary progressive (SP) MS is still debated. We aim to compare long-term clinical
evolution of newly-diagnosed RRMS patients treated with different Interferon-β formulations.
Methods
507 patients were included in the analysis and followed-up for 8.5 ± 3.9 years. 37.6%
were treated with subcutaneous Interferon-β1a 44 mcg, 33.4% with intramuscular Interferon-β1a 30 mcg, and 29.0% with subcutaneous Interferon-β1b 250 mcg. Relapse occurrence, 1-point EDSS progression, reaching of EDSS 4.0 and conversion
to SP were recorded as outcome measures. To reduce the selection bias, we calculated
the propensity score of receiving the specific treatment considering age (32.7 ± 8.3
years), gender (female 63.1%), disease duration (2.7 ± 2.8 years), and baseline EDSS
(1.5, range 1.0–3.5). Propensity score and covariates (age, gender, disease duration
and EDSS) were included in the statistical models.
Results
At Cox regression models, the reaching of EDSS 4.0 was not-significantly higher for
Interferon-β1b 250 mcg (HR = 1.207; p = 0.063) and for Interferon-β1a 30 mcg (HR = 1.363; p = 0.095), when compared with Interferon-β1a 44 mcg. The rate of SP conversion was higher for Interferon-β1b 250 mcg (HR = 2.054; p = 0.042), and not-significantly higher for Interferon-β1a 30 mcg (HR = 1.884; p = 0.081), when compared with Interferon-β1a 44 mcg.
Conclusions
Patients treated with Interferon-β1a 44 mcg presented with a marginally reduced risk of disability accrual in the long-term,
when compared with Interferon-β1b 250 mcg and, at least in part, with Interferon-β1a 30 mcg. Formulation, frequency of administration and dose of Interferon-β might affect
the long-term clinical evolution of RRMS.
Keywords
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Article info
Publication history
Published online: November 06, 2017
Accepted:
November 5,
2017
Received in revised form:
October 13,
2017
Received:
August 23,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
