Sunday, 14 August 2016

Long term follow up of beta interferon use

Kappos L, Edan G, Freedman MS, Montalb├ín X, Hartung HP, Hemmer B, Fox EJ, Barkhof F, Schippling S, Schulze A, Pleimes D, Pohl C, Sandbrink R, Suarez G, Wicklein EM; BENEFIT Study Group The 11-year long-term follow-up study from the randomized BENE:FIT CIS trial. Neurology. 2016 Aug 10. pii: 10.1212/WNL.0000000000003078. [Epub ahead of print]

To assess outcomes for patients treated with interferon beta-1b immediately after clinically isolated syndrome (CIS) or after a short delay.
METHODSParticipants in BENEFIT (Betaferon/Betaseron in Newly Emerging MS for Initial Treatment) were randomly assigned to receive interferon beta-1b (early treatment) or placebo (delayed treatment). After conversion to clinically definite multiple sclerosis (CDMS) or 2 years, patients on placebo could switch to interferon beta-1b or another treatment. Eleven years after randomization, patients were reassessed.
RESULTS: Two hundred seventy-eight (59.4%) of the original 468 patients (71.3% of those eligible at participating sites) were enrolled (early: 167 [57.2%]; delayed: 111 [63.1%]). After 11 years, risk of CDMS remained lower in the early-treatment arm compared with the delayed-treatment arm (p = 0.0012), with longer time to first relapse (median [Q1, Q3] days: 1,888 [540, not reached] vs 931 [253, 3,296]; p = 0.0005) and lower overall annualized relapse rate (0.21 vs 0.26; p = 0.0018). Only 25 patients (5.9%, overall; early, 4.5%; delayed, 8.3%) converted to secondary progressive multiple sclerosis. Expanded Disability Status Scale scores remained low and stable, with no difference between treatment arms (median [Q1, Q3]: 2.0 [1.0, 3.0]). The early-treatment group had better Paced Auditory Serial Addition Task-3 total scores (p = 0.0070). Employment rates remained high, and health resource utilization tended to be low in both groups. MRI metrics did not differ between groups.
CONCLUSIONS: Although the delay in treatment was relatively short, several clinical outcomes favored earlier treatment. Along with low rates of disability and disease progression in both groups, this supports the value of treatment at CIS.
You can read the head lines and it is nothing new, the study says start treating as early as possible and you gain more benefit in the long term

1 comment:

  1. CRABs drugs should have no place in treatment of any form of MS as shown by results from the same study. Your thoughts MD?

    "Drugs such as interferon beta-1b have been shown to reduce the frequency and severity of flare-ups, but don’t appear to actually help reduce or prevent the actual damage being done to the brain, even when taken as early as possible. Indeed, the researchers of the current study found there were no differences in neurological damage or overall disability experienced between the groups.
    'Overall, early treatment appears to have a benefit on relapses, especially early in the disease, but limited effects on other outcome measures, including outcomes reported by patients,' wrote Dr. Brian C. Healy, a neurologist at Brigham and Women’s Hospital and Massachusetts General Hospital in Boston, in an accompanying editorial."
    Source: Medical Daily © 2016 IBT Media Inc (11/08/16)

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