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                                                                                          Dott. Carlo Sebastiano Tadeo
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Starting Interferon Beta-1a Inititally May Slow Multiple Sclerosis Progression


Effect of early interferon treatment on conversion to definite multiple sclerosis: a randomised study
Lancet

17/05/2001
By Harvey McConnell


Initiation of interferon beta-1a at initial diagnosis of multiple sclerosis may reduce neurological and clinical symptoms of disease progression.

Interferon beta reduces activity in multiple sclerosis, as measured clinically and by magnetic resonance imaging (MRI). Dr Giancario Comi and colleagues at the Department of Neuroscience, Scientific Institute The University of Milan, Milan, Italy, and at 57 medical centers in 14 European countries assessed the effect of interferon beta-1a on the occurrence of relapses in patients after first presentation with neurological events, who are at high risk of conversion to clinically definite multiple sclerosis.

In the trial, 308 eligible patients had had a first episode of neurological dysfunction suggesting multiple sclerosis within the previous three months and had strongly suggestive brain MRI findings. Patients were randomly assigned interferon beta-1a 22 mg, or placebo, subcutaneously once weekly over two years.

Neurological and clinical assessments were carried out every six months and brain MRI every 12 months. At the end of the trial 278 (90 percent ) of patients remained. There were 57 patients (85 percent ) of 67 patients who stopped therapy after conversion to clinically definite multiple sclerosis.

Clinicians found that fewer patients (34 percent) in the interferon groups developed clinically definite multiple sclerosis in the interferon group than in the placebo group (45 percent). A period of time at which 30 percent of patients had converted to clinically definite multiple sclerosis was 569 days in the interferon group, compared with 252 days in the placebo group.

Dr Comi and colleagues said that while it is not proven, indications "suggests that early multiple sclerosis is more sensitive to the therapeutic effect of interferon beta-1a than more advanced disease. The therapeutic benefit on relapses is supported by the MRI findings, in which both lesion activity and the accumulation of lesion burden were reduced compared with placebo.

Among the various effects on MRI, we observed that interferon beta-1a also resulted in a significant increase in the proportion of patients with absence of any MRI activity over two years."

Injection-site reactions among the patients were common, but they were mostly mild, and injection-site necrosis was not observed. Good tolerability contributed to good compliance in the trial, the clinicians concluded.


Lancet 2001; 357: 1576-82. "Effect of early interferon treatment on conversion to definite multiple sclerosis: a randomised study"

 

 

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Aggiornato il: 18 November 2001