High-dose, frequently administered interferon beta therapy for relapsing–remitting multiple sclerosis must be maintained over the long term: the interferon beta dose-reduction study

Abstract 

Long-term trials have demonstrated the continued efficacy of interferon (IFN) beta treatment in patients with relapsing–remitting (RR) multiple sclerosis (MS) during prolonged administration.

The objective of the work was to evaluate the effects of reducing IFN beta administration frequency and total weekly dose in patients with RR MS who have achieved clinical and MRI disease activity stabilization during long-term IFN beta-1b treatment. Prospective 1-year follow-up of 27 RR MS patients on long-term 250 μg every other day (standard dose) IFN beta-1b treatment were randomized either to gradually reduce dose to 30 μg once-a-week IFN beta-1a (13 patients), or to continue on IFN beta-1b standard dose (14 patients).

We found significant differences in the two group of patients. In the group of patients continuously treated with IFN beta-1b standard dose, 79% remained relapse free compared to 23% in the group receiving once-weekly IFN beta-1a (p=0.006). The number of patients without new PD/T2 lesions was higher in the group of patients continuously treated with IFN beta-1b standard dose (77%) compared to the once-weekly IFN beta-1a group (23%) (p=0.04). IFN beta is a long-term treatment for MS. The reduction of IFN beta-1b administration frequency and dose is not advisable even in patients free from clinical and MRI disease activity for many years.

Keywords:  Interferon beta-1a, Interferon beta-1b, Interferon beta dose reduction, Multiple sclerosis, Relapsing–remitting, Relapses, Disease progression, Magnetic resonance imaging