Early interferon beta-1b treatment beneficial in patients with multiple sclerosis

Early treatment of multiple sclerosis improved clinical outcomes and delayed relapses.
Early treatment of multiple sclerosis improved clinical outcomes and delayed relapses.

Early interferon beta-1b treatment could improve clinical outcomes in patients with multiple sclerosis (MS) after clinically isolated syndrome (CIS), according to a study published in Neurology.

Ludwig Kappos, MD, from the Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering at the University Hospital Basel in Switzerland, and colleagues assessed the outcomes in 278 patients in the BENEFIT (Betaferon/Betaseron in Newly Emerging MS for Initial Treatment) trial.

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The participants were randomly assigned to receive interferon beta-1b early treatment or placebo, which was considered “delayed treatment.” Patients in the placebo group switched to interferon beta-1b or another treatment after 2 years, or after conversion to clinically definite multiple sclerosis (CDMS). The patients were reassessed after 11 years of follow-up.

“Despite the relatively short delay in treatment initiation in the placebo group, measures reflecting clinical disease activity such as time to CDMS, time to first relapse, and relapse rates, as well as scores on the PASAT, the only neuropsychological test applied from baseline to year 11, still suggest persistent long-term benefits of the earlier treatment,” the authors wrote.

After the 11-year follow-up period, patients who received early treatment had a lower risk of CDMS compared with patients in the placebo group. Patients in the early treatment group also had a longer median time to the first relapse (1888 days vs 931 days) and a lower overall annual relapse rate (0.21 vs 0.26). Overall, 25 patients converted to secondary progressive MS.

The Expanded Disability Status Scale scores were low and stable in both treatment groups (median: 2.0), although the early treatment group had improved Paced Auditory Serial Addition Task-3 total scores. The researchers also noted that employment rates were high, and use of health resources was generally low in both groups.

“Despite the inherent problems of a comparison with natural course studies, our results indicate that early treatment with interferon beta-1b had a long-lasting, even remote, beneficial effect on disease activity as well as cognitive outcomes, resource utilization, and employment rate,” the investigators wrote.  “Taken together, the findings of BENEFIT 11 reinforce the importance of starting therapy with interferon beta-1b as soon as possible after the onset of MS symptoms.”

Reference

Kappos L, Edan G, Freedman MS, et al. The 11-year long-term follow-up study from the randomized BENEFIT CIS trial. Neurology. 2016; doi: 10.1212/WNL.0000000000003078. 
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