Doing badly on beta interferon

Hartung HP, Kappos L, Goodin DS, O’Connor P, Filippi M, Arnason B, Comi G, Cook S, Jeffery D, Petkau J, White R, Bogumil T, Beckmann K, Stemper B, Suarez G, Sandbrink R, Pohl C. Predictors of disease activity in 857 patients with MS treated with interferon beta-1b.J Neurol. 2015 Aug 5. [Epub ahead of print]

Multiple sclerosis (MS) is a chronic demyelinating neurodegenerative disease of the CNS that requires long-term treatment. The identification of patient characteristics that can help predict disease outcomes could improve care for patients with MS. The objective of this study is to identify predictors of disease activity in patients from the BEYOND trial. This regression analysis of patients with relapsing-remitting MS from BEYOND examined the predictive value of patient characteristics at baseline and after 1 year of treatment with interferon beta-1b 250 μg every other day for clinical and MRI outcomes after year 1 of the study. 857 and 765 patients were included in the analyses of clinical and MRI outcomes, respectively. Age, a higher number of relapses in the past 2 years, ≥3 new MRI lesions in the first year, and, especially, a higher number of relapses in year 1 predicted the future occurrence of relapses. By contrast, age, MRI activity, and the presence of neutralizing antibodies in the first year were principally predictive of future MRI activity. In patients with continued clinical disease activity or substantial MRI activity on therapy, an alternative therapeutic approach should be strongly considered.

You can all read the conclusions and as to the last sentence I suspect you will be saying NSS (no…****…sherlock). Surely it is  BEYOND belief that neuros are happy that people are having relapses and lesions and not switching for more effective treatments. If you are having neutralising antibodies, the interferon will not work, so why wait until relapses occur before a switch?

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  • Agreed MD, why wait to switch if there is a predictive test that reveals how well a patient will (continue to) respond to interferon treatment? Should testing for NABS be routine then for all patients on interferon treatment?

  • Wouldn't you just assume that interferons are doing their job if no symptoms or MRI activity were present?

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