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Interferons-beta versus glatiramer acetate for relapsing-remitting multiple sclerosis.

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Interferons-beta (IFNs-beta) and glatiramer acetate (GA) show similar clinical effectiveness in treating relapsing-remitting multiple sclerosis (RRMS) over 24 months. However, IFNs-beta demonstrated a greater reduction in MRI lesion burden compared to GA.

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Area of Science:

  • Neurology
  • Immunology
  • Pharmacology

Background:

  • Interferons-beta (IFNs-beta) and glatiramer acetate (GA) are the first disease-modifying therapies (DMTs) for multiple sclerosis (MS).
  • DMT prescription rates and costs have risen significantly over the past decade.
  • Choosing a DMT requires balancing risk/benefit profiles and impact on quality of life.

Purpose of the Study:

  • To systematically review head-to-head trials comparing the effectiveness of IFNs-beta and GA in treating relapsing-remitting MS (RRMS).
  • To update previous Cochrane reviews on this topic.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Searched Cochrane Multiple Sclerosis and Rare Diseases of the CNS Group Trials Register and other sources.
  • Included RCTs directly comparing IFNs-beta versus GA in participants with RRMS.

Main Results:

  • Six trials involving 2904 participants were analyzed.
  • Similar clinical efficacy (relapse rate, progression) observed at 24 months.
  • IFNs-beta showed a greater reduction in T2 and T1 lesion volume on MRI compared to GA.
  • Similar rates of study withdrawal due to adverse events were reported for both therapies.
  • Quality of evidence for primary outcomes was moderate, but low for safety and some MRI outcomes.

Conclusions:

  • IFNs-beta and GA demonstrate comparable clinical effects in RRMS treatment, with minor differences observed.
  • IFNs-beta appear more effective in limiting MRI lesion load accrual compared to GA.
  • Insufficient evidence exists to compare the impact of these DMTs on patient-reported outcomes like quality of life.