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Area of Science:

  • Neuroimmunology
  • Psychiatry
  • Clinical Therapeutics

Background:

  • Multiple Sclerosis (MS) treatment guidelines often favor glatiramer acetate (GA) over interferon beta (IFNβ) for patients with a history of depression.
  • This prescribing preference is based on a belief that IFNβ may increase depression risk during MS treatment.

Purpose of the Study:

  • To investigate the relationship between disease-modifying therapy (DMT) type (IFNβ vs. GA) and depression in patients with relapsing-remitting MS (RRMS).
  • To determine if initial DMT choice impacts depressive symptom changes over time.

Main Methods:

  • Retrospective review of medical records for RRMS patients treated between 2000-2007.
  • Inclusion criteria: patients remaining on a single course of either IFNβ or GA therapy.
  • Depression assessment using Beck Depression Inventory (BDI) scores at baseline and every 6 months for up to 4 years.

Main Results:

  • No statistically significant differences in the mean change of BDI scores were observed between the IFNβ and GA groups from baseline to 48 months.
  • Analysis revealed no significant differences in BDI score changes between patients treated with antidepressants and those not treated within either the IFNβ or GA subgroups.
  • These findings suggest neither IFNβ nor GA exacerbates depressive symptoms in RRMS patients on initial therapy.

Conclusions:

  • Current evidence does not support the hypothesis that interferon beta (IFNβ) is more likely to increase depression than glatiramer acetate (GA) in patients with multiple sclerosis (MS).
  • Both IFNβ and GA appear to be safe regarding depressive symptoms in RRMS patients initiating these DMTs.
  • Clinical decisions regarding initial DMT choice for RRMS patients should consider factors beyond perceived depression risk associated with IFNβ vs. GA.