Interferon treatment may trigger primary headaches in multiple sclerosis patients

Area of Science:

• Neurology
• Immunology

Background:

• Interferon-beta (IFN-beta) is a common treatment for multiple sclerosis (MS).
• Emerging data suggest a potential link between IFN-beta and headache aggravation in MS patients.

Purpose of the Study:

• To investigate the lifetime prevalence of primary headaches in MS patients treated with interferons.
• To compare headache incidence and changes in pre-existing headaches in interferon-treated MS patients versus those on other disease-modifying agents.
• To analyze the onset of headache in relation to therapy initiation.

Main Methods:

• An open-label, non-randomized study of 150 consecutive MS patients.
• Patients were divided into two groups: 109 treated with IFN-beta (1a or 1b) and 41 treated with other disease-modifying agents (glatiramer acetate or azathioprine).
• Semi-structured interviews were conducted to diagnose headache types based on International Headache Society criteria.

Main Results:

• The frequency of primary headaches was significantly higher in the IFN-beta group (72%) compared to the other treatment group (54%) (P=0.03).
• Worsening of pre-existing headaches occurred in 41% of the IFN-beta group, and de novo headaches developed in 48% of this group.
• No new or worsening headaches were reported in the group treated with other disease-modifying agents (P<0.001).

Conclusions:

• Headache should be recognized as a potential side-effect of interferon therapy in multiple sclerosis patients.
• Interferon treatment is associated with both the development of new headaches and the exacerbation of pre-existing headaches.