Interferon benefits early multiple sclerosis


by Will Boggs, 4 Oct 2006

NEW YORK (Reuters Health) - Early and ongoing treatment with interferon beta-1a can provide lasting benefits to patients with relapsing-remitting multiple sclerosis (MS), according to a report in the journal Neurology.

Multiple sclerosis is thought to be an autoimmune disease, a disease that occurs when the body's own immune system attacks a key protein covering on the nerves, resulting in serious movement problems and other symptoms.

With relapsing-remitting MS, the initial form of the disease in 85 percent of patients, MS attacks are separated by periods of relatively normal function.

"Long-term treatment with (interferon beta-1a) is feasible and tolerated by most patients with some evidence of sustained benefit regarding clinical disease progression and MRI related outcomes," Dr. Ludwig Kappos from University Hospital Basel, Switzerland told Reuters Health.

Kappos and colleagues report follow-up data for up to 8 years after entry of patients into the Prevention of Relapses and Disability by Interferon beta-1a Subcutaneously in Multiple Sclerosis (PRISMS) study.

Early treatment with interferon beta-1a, particularly at a high dose, helped prevent disease relapses, the researchers note. Moreover, early treatment appeared to slow long-term disease progression based on MRI findings.

Treatment with interferon was generally well tolerated, the investigators say, with no new safety concerns.

"This trial represents another enormous expenditure of effort to determine whether we are helping our relapsing-remitting MS patients with existing therapies," writes Dr. John H. Noseworthy from the Mayo Clinic College of Medicine, Rochester, Minnesota in a related editorial.

"I respect this effort," Noseworthy concludes, "but am cautious about the authors' conclusions that 'patients with relapsing-remitting MS can experience sustained benefit over many years from early interferon beta-1a...three times weekly therapy.' Perhaps this is true (I hope it is), but the evidence is not yet fully convincing to me."

Kappos responded: "Noseworthy is correct in that this study did only provide indicative evidence for efficacy as it did not have an untreated (comparison) group from year 3 onwards and because at the end of the day we do not know what the impact of those patients who did not complete the follow-up would have been."

Nonetheless, he concluded, "Justification of early treatment with not only based on this observation but also on data from early treatment studies and from new insights in the neuropathology of early and late phases of MS."

SOURCE: Neurology, September 2006.