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Interferon-Beta-Induced Headache in Patients with Multiple Sclerosis: Frequency and Characterization

Alaa Elmazny1, Sherif M Hamdy1, Maged Abdel-Naseer1

  • 1Neurology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Journal of Pain Research
|March 27, 2020
PubMed
Abstract

Insights

Interferon-beta (IFN-β) treatment for multiple sclerosis (MS) can worsen existing headaches or cause new ones. The risk of headaches is higher with intramuscular (IM) INF-β-1a and 44 μg subcutaneous (SC) INF-β-1a compared to 22 μg SC INF-β-1a.

Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Interferon-beta (IFN-β) is a common treatment for multiple sclerosis (MS).
  • Headaches are a frequent adverse effect of IFN-β therapy, impacting patient quality of life.
  • Understanding headache patterns in response to IFN-β is crucial for MS management.

Purpose of the Study:

  • To investigate the frequency, patterns, and characteristics of headaches in patients with relapsing-remitting multiple sclerosis (RRMS) treated with IFN-β.
  • To analyze the temporal relationship between IFN-β treatment initiation and headache onset or exacerbation.
  • To identify risk factors associated with IFN-β-induced headaches.

Main Methods:

  • Prospective, longitudinal study with 1-year follow-up of 796 RRMS patients treated with IFN-β.
  • Headache diagnosis based on the International Classification of Headache Disorders (ICHD-3).
  • Data collected via interviewer-administered Arabic questionnaire assessing headache characteristics and treatment relationship.

Main Results:

  • 356 patients developed new (de novo) headaches, and 276 had pre-existing headaches that worsened.
  • Among those with pre-existing headaches, 55 experienced worsening after starting IFN-β.
  • Increased headache risk observed with intramuscular INF-β-1a (OR 6.51) and 44 μg subcutaneous INF-β-1a (OR 5.44) compared to 22 μg SC INF-β-1a.

Conclusions:

  • IFN-β therapy can induce primary headaches and exacerbate pre-existing headaches in MS patients.
  • Treatment with intramuscular INF-β-1a and higher-dose subcutaneous INF-β-1a (44 μg) is associated with a greater risk of headaches.
Keywords:
headacheinterferon-betamultiple sclerosis

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