Interferon beta prescribed drug treatment may not prevent disease progression
Researchers with the UBC Hospital MS Clinic and Brain Research Center at Vancouver Costal Health and the University of British Columbia have published a new study with important information about the impact of a common drug therapy on the progression of multiple sclerosis (MS) for people with the relapsing-remitting form of the disease.View slideshow: Adjunct therapies for MS
Interferon beta drugs affect the immune system and help in fighting viral infections, prevent inflammation and demyelination in the central nervous system. These drugs also limit the activity of gamma interferon (protein produced by the immune system) that makes MS worse.
These medicines are also used to treat people with MS who have relapses followed by periods of recovery (relapse-remitting MS).
Drs. Helen Tremlett, Afsaneh Shirani, Joel Oger and others demonstrate there is no strong evidence that these group of drugs, beta interferon (β-IFNs), prescribed for the treatment of MS had a measurable impact on the long-term disability progression of the disease.
Researchers analyzed the linked health records between 1985 and 2008 in a retrospective cohort study consisting of 2656 of multiple sclerosis patients from PharmaNet., Canada, with relapsing-remitting MS and who were followed from four to eleven years. The data sources had included the BC Ministry of Health, the BC Multiple Sclerosis data base and
The study population included patients with MS who were treated with beta interferon’s (β-IFNs), the most widely used treatment for relapsing‑remitting MS, as well as untreated MS patients. The research team discovered that administration of β-IFN was not associated with a significant change in the progression of disability.
These findings will be of interest to MS patients with this form of the disease, but researchers are quick to point out that this is just one measure of these disease modifying drugs and there is still potentially significant benefit to patients.
Dr. Helen Tremlett, PhD, who holds the Canada Research Chair in Neuroepidemiology and Multiple Sclerosis at UBC and corresponding author of study stated in a public release "What this study provides is additional information to patients and clinicians about the longer term effect of this class of drugs.” We know that this class of drugs is very helpful in reducing relapses, which can be important to patients. We do not recommend that patients stop taking these medications, but these findings provide evidence, allowing more realistic expectations as to the anticipated benefits associated with drug treatment from the disability perspective."
Dr. Afsaneh Shirani, who is the first author of the paper and a post-doctoral research fellow in the UBC Faculty of Medicine and Brain Research Centre at UBC and VCH Research Institute, said "It is still possible that some patients gain long-term benefit from β-IFNs. We are currently working toward identifying who those potential treatment responders might be." "Our study also encourages the investigation of novel treatments for MS.”
Dr Shirani states "In addition, this study suggests that linked data from health administrative databases have enormous potential for research applications, despite all the challenges of record linkage.”
Relapsing-remitting MS is characterized by unpredictable acute attacks, called "exacerbations," with worsening of symptoms followed by full, partial, or no recovery of some function. These attacks appear to evolve over several days to weeks. Recovery from an attack takes weeks sometimes months. The disease does not worsen in the periods between the attacks. This pattern usually occurs early in the course of MS in most people, according to WebMD.
Relapsing-remitting MS is the most common form of MS affecting around 85% of MS patients in Canada.
Researchers had concluded “we did not find evidence that administration of interferon beta was associated with a reduction in disability progression in patients with relapsing-remitting MS."
However, researchers do note that it may be possible that some groups of MS patients may benefit from treatment with these drugs and that it was not apparent from their analysis.
Researchers add “Further work is needed to identify these potential patients; perhaps through pharmacogenomics or biomarker studies, paving the way for a tailored, personalized medicine approach. Our findings also encourage the investigation of novel therapeutics for MS.”
Dr. Joel Oger, neurologist at UBC Hospital MS Clinic stated "This study following a large number of patients for a long time in "real life situation" does not show an association of the β-IFNs with long term disability and tends to confirm a more modern way of understanding MS: relapses may not be responsible for long term disability in all patients and another mechanism might be at work as well."
The research team are preparing for future studies further examining this drug and other classes of disease modifying drugs. Researchers hope the research will eventually lead to an individualized approach to the treatment of MS.
This study appears in today’s issue of the Journal of the American Medical Association.
People with MS who have relapses within the first five years of onset appear to have more severe disability in the short term compared to people without early relapse, the author of that study was Dr. Helen Tremlett, PhD, published in November 4th 2009, issue of Neurology®, the medical journal of the American Academy of Neurology.
Scientists continue to actively search for the cause of MS. Researchers are dedicated to hopefully find a cure and most importantly prevention of MS.