Switching to second-line therapies in interferon-beta-treated relapsing-remitting multiple sclerosis patients

European Neurology
E PortaccioM P Amato

Abstract

Interferon-beta (IFNB) therapies are the most widely used as first-line intervention in the treatment of relapsing-remitting (RR) multiple sclerosis (MS). Despite long-term experience, however, the definition and prediction of response remain controversial. The objective of this study was to assess the long-term validity of the main clinical definitions of response applied after 1 and 2 years of IFNB therapy in a cohort of RRMS patients followed up for at least 5 years. We tested these different definitions against a 'hard' parameter of treatment failure, represented by the need to suspend IFNB and switch to an intravenous immunosuppressive (IVIS) treatment, using Kaplan-Meier and Cox survival analyses. Out of 147 RRMS patients treated with IFNB therapy and followed up for 7.8 +/- 2.1 years, 26 (18%) were switched to an IVIS therapy. On the whole, disability progression as indicated using the Expanded Disability Status Scale (EDSS) and a higher number of relapses in the first 2 years of therapy were related to long-term treatment failure. Our study highlights the role of disability and high relapse rate in the first 2 years of treatment in predicting long-term response and the switching to second-line therapies.

Citations

Mar 20, 2013·CNS Drugs·Patricia K Coyle
May 25, 2013·Journal of Neurology, Neurosurgery, and Psychiatry·L MichelD A Laplaud
Feb 4, 2014·Mayo Clinic Proceedings·Dean M Wingerchuk, Jonathan L Carter
Apr 22, 2015·Multiple Sclerosis and Related Disorders·K O'ConnellN Tubridy
Nov 28, 2013·Multiple Sclerosis : Clinical and Laboratory Research·Barbara TeterBianca Weinstock-Guttman

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