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Beta-interferon exposure and onset of secondary progressive multiple sclerosis
1Division of Neurology and Brain Research Centre, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Background And Purpose:
Beta-interferons (IFNβ) are the most widely prescribed drugs for patients with multiple sclerosis (MS). However, whether or not treatment with IFNβ can delay secondary progressive MS (SPMS) onset remains unknown. Our aim was to examine the association between IFNβ exposure and SPMS onset in patients with relapsing-remitting MS (RRMS).
Methods:
A retrospective cohort study using British Columbia (Canada) population-based clinical and health administrative data (1985-2008) was conducted. RRMS patients treated with IFNβ (n = 794) were compared with untreated contemporary (n = 933) and historical (n = 837) controls. Cohort entry was the first clinic visit during which patients became eligible for IFNβ treatment (baseline). The outcome was time from baseline to SPMS onset. Cox regression models with IFNβ as a time-dependent exposure were adjusted for sex, and baseline age, disease duration, disability, *socioeconomic status and *comorbidities (*available for the contemporary cohorts only). Additional analyses included propensity score adjustment.
Results:
The median follow-up for the IFNβ-treated, untreated contemporary and historical controls were 5.7, 3.7 and 7.3 years, and the proportions of patients reaching SPMS were 9.2%, 11.8% and 32.9%, respectively. After adjustment for confounders, IFNβ exposure was not associated with the risk of reaching SPMS when either the contemporary or the historical untreated cohorts were considered (hazard ratio 1.07; 95% confidence interval 0.93-1.48, and hazard ratio 1.04; 95% confidence interval 0.74-1.46, respectively). Further adjustments and the propensity score yielded results consistent with the main analysis.
Conclusions:
Amongst patients with RRMS, use of IFNβ was not associated with a delayed onset of SPMS.
Insights
Beta-interferons (IFNβ) do not delay the onset of secondary progressive multiple sclerosis (SPMS) in patients with relapsing-remitting MS (RRMS). This study found no significant association between IFNβ treatment and the progression to SPMS.
Area of Science:
- Neurology
- Immunology
- Pharmacology
Background:
- Beta-interferons (IFNβ) are primary treatments for multiple sclerosis (MS).
- The efficacy of IFNβ in delaying the progression from relapsing-remitting MS (RRMS) to secondary progressive MS (SPMS) is not well established.
Purpose of the Study:
- To investigate the association between IFNβ exposure and the onset of SPMS in RRMS patients.
- To determine if IFNβ treatment influences the time to progression to SPMS.
Main Methods:
- Retrospective cohort study utilizing Canadian health administrative data (1985-2008).
- Comparison of RRMS patients treated with IFNβ (n=794) against untreated contemporary (n=933) and historical (n=837) controls.
- Cox regression models and propensity score analysis adjusted for relevant covariates.
Main Results:
- Median follow-up durations were 5.7 years (IFNβ), 3.7 years (contemporary), and 7.3 years (historical).
- SPMS incidence was 9.2% (IFNβ), 11.8% (contemporary), and 32.9% (historical).
- Adjusted analyses revealed no significant association between IFNβ exposure and the risk of SPMS onset (HRs approx. 1.04-1.07).
Conclusions:
- IFNβ treatment is not associated with a delay in the onset of SPMS in patients initially diagnosed with RRMS.
- Findings suggest IFNβ does not alter the natural disease course regarding progression to the progressive phase of MS.
