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For those of you who dabble in MS medication, but don't take your shots as often as you should, this retrospective study does make one think. - Dave
Continuous Disease-Modifying Treatment Without Interruptions Provides Better Long-Term Outcomes in Multiple Sclerosis: Presented at ENS
By Judith Moser, MD
MILAN, Italy -- June 23, 2009 -- Patients with multiple sclerosis (MS) who adhere to their treatment with interferon (IFN) beta-1a without interruption have lower relapse and progression rates than patients who do not adhere to their medication as regularly, said researchers here at the 19th Meeting of the European Neurological Society (ENS).
In the Prevention of Relapses and disability by Interferon beta-1a Subcutaneously in Multiple Sclerosis (PRISMS) study, IFN beta-1a 22 or 44 mcg administered subcutaneously 3 times weekly proved effective in reducing relapses and delaying disability progression in patients with relapsing-remitting multiple sclerosis (RRMS) compared with placebo.
After the initial 2-year double-blind phase, patients originally randomised to placebo were re-randomised to IFN beta-1a 22 or 44 mcg 3 times weekly for an additional 2 years.
On study completion, all patients were offered the choice of continuing to receive blinded or open-label treatment during years 5 to 6. Beyond year 6, patients could continue on any or no disease-modifying drug.
Data from the long-term follow-up (LTFU, up to 8 years) supported the efficacy of the treatment.
Bernard M.J. Uitdehaag, MD, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands, presented the results of a post hoc exploratory analysis of the LTFU cohort on June 22.
The analysis evaluated only the long-term clinical efficacy outcomes in the group of patients who were originally randomised to IFN beta-1a 44 mcg, focussing on continuity of treatment. Clinical outcomes of patients who were treated continuously (n = 45) were compared with those who had had some medication interruptions (n = 91).
"Patients in the continuous group had a lower mean annualised relapse rate than those in the noncontinuous group," Dr. Uitdehaag explained. From baseline to LTFU, the annualised relapse rates were 0.51 and 0.61 in the continuous and noncontinuous groups, respectively.
The proportion of patients who were free from relapses was similar between groups (13.3% and 16.5% in the continuous and noncontinuous groups, respectively).
Confirmed Expanded Disability Status Scale progression rates at 3 months were higher in patients with noncontinuous treatment (64.8% vs 46.7%).
In addition, a lower proportion of patients in the continuous group converted to secondary progressive MS compared with the noncontinuous group (11.1% vs 25.3%).
Although the potential effect of other factors must be considered and confounding cannot be excluded, these data suggest that better outcomes may be expected in patients who adhere to treatment and who avoid treatment interruptions over the long term.
"Of course these are only retrospective data, and we cannot prove the causality," Dr. Uitdehaag emphasised.
The researchers plan to assess whether the outcomes have been reached before or after stopping the medication on an individual level because it is difficult to determine on a group level, according to Dr. Uitdehaag.
Funding for this study was provided by Merck Serono S.A.
[Presentation title: Continuous Versus Non-Continuous Subcutaneous Interferon Beta-1a Treatment in Relapsing-Remitting Multiple Sclerosis: Long-Term Data From the PRISMS Study. Abstract P 346]
Continuous Disease-Modifying Treatment Without Interruptions Provides Better Long-Term Outcomes in Multiple Sclerosis: Presented at ENS
By Judith Moser, MD
MILAN, Italy -- June 23, 2009 -- Patients with multiple sclerosis (MS) who adhere to their treatment with interferon (IFN) beta-1a without interruption have lower relapse and progression rates than patients who do not adhere to their medication as regularly, said researchers here at the 19th Meeting of the European Neurological Society (ENS).
In the Prevention of Relapses and disability by Interferon beta-1a Subcutaneously in Multiple Sclerosis (PRISMS) study, IFN beta-1a 22 or 44 mcg administered subcutaneously 3 times weekly proved effective in reducing relapses and delaying disability progression in patients with relapsing-remitting multiple sclerosis (RRMS) compared with placebo.
After the initial 2-year double-blind phase, patients originally randomised to placebo were re-randomised to IFN beta-1a 22 or 44 mcg 3 times weekly for an additional 2 years.
On study completion, all patients were offered the choice of continuing to receive blinded or open-label treatment during years 5 to 6. Beyond year 6, patients could continue on any or no disease-modifying drug.
Data from the long-term follow-up (LTFU, up to 8 years) supported the efficacy of the treatment.
Bernard M.J. Uitdehaag, MD, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands, presented the results of a post hoc exploratory analysis of the LTFU cohort on June 22.
The analysis evaluated only the long-term clinical efficacy outcomes in the group of patients who were originally randomised to IFN beta-1a 44 mcg, focussing on continuity of treatment. Clinical outcomes of patients who were treated continuously (n = 45) were compared with those who had had some medication interruptions (n = 91).
"Patients in the continuous group had a lower mean annualised relapse rate than those in the noncontinuous group," Dr. Uitdehaag explained. From baseline to LTFU, the annualised relapse rates were 0.51 and 0.61 in the continuous and noncontinuous groups, respectively.
The proportion of patients who were free from relapses was similar between groups (13.3% and 16.5% in the continuous and noncontinuous groups, respectively).
Confirmed Expanded Disability Status Scale progression rates at 3 months were higher in patients with noncontinuous treatment (64.8% vs 46.7%).
In addition, a lower proportion of patients in the continuous group converted to secondary progressive MS compared with the noncontinuous group (11.1% vs 25.3%).
Although the potential effect of other factors must be considered and confounding cannot be excluded, these data suggest that better outcomes may be expected in patients who adhere to treatment and who avoid treatment interruptions over the long term.
"Of course these are only retrospective data, and we cannot prove the causality," Dr. Uitdehaag emphasised.
The researchers plan to assess whether the outcomes have been reached before or after stopping the medication on an individual level because it is difficult to determine on a group level, according to Dr. Uitdehaag.
Funding for this study was provided by Merck Serono S.A.
[Presentation title: Continuous Versus Non-Continuous Subcutaneous Interferon Beta-1a Treatment in Relapsing-Remitting Multiple Sclerosis: Long-Term Data From the PRISMS Study. Abstract P 346]