impact of IFN beta 1a and IFN beta-1b on the clinical and MRI responses in patients with relapsing-remitting multiple sclerosis

ABSTRACT

Multiple Sclerosis [MS] is a common demyelinating and inflammatory disease of the CNS with a presumed autoimmune etiology. IFN beta-1a and IFN beta-1b have a proven treatment effect on RRMS presumably through its regulatory properties on T-cell activation and cytokines production. Here we studied the clinical and MRI effects of these drugs in four groups of clinically and laboratory [Cerebrospinal fluid evaluation revealed elevation of immunoglobulin [IgG] synthesis rate and oligoclonal bands] definite RRMS patients for 18 months. In IFN beta-1a group [n = 25], the patients used IFN beta-la 30 micro g [6MU] intramuscular once a week, the other three groups of IFN beta-1a [n = 25] 22 micro g [6MU], IFN beta-la 44 micro g [n = 25] and IFN beta-1b 8MU [0.25 mg] [n = 25] were injected subcutaneously 3-time a week. In comparison with the pre-treatment values, reduction in the relapse rate was statistically significant in IFN beta-la 44 micro g, IFN beta-la 30 micro g and IFN beta-lb 8MU groups more than IFN beta-la 22 micro g [P < 0.001, 0.008, 0.001 and > 0.5 respectively], and the mean EDSS significantly reduced in the IFN beta-lb [P < 0.001], IFN beta-la intramuscular [P < 0.02] and 44 micro g IFN beta-la [P < 0.001], in contrast to 22 micro g IFN beta-la treated patients [P > 0.5]. Moreover, IFN beta-lb [P < 0.001] and 44ug IFN beta-la [P < 0.003] groups showed highly statistical significant reduction in MRI disease activity load [p < 0.05] in comparison with 22micro g IFN beta-1a [p < 0.5] and IFN beta-la intramuscular groups [p < 0.07]. The study confirmed also the effect of beta-IFNs on the short term physical disability scale [p < 0.01] while they have no significant effect on long term disability scale [p > 0.64]. Additionally, beta-IFNs groups showed no statistically significant severe drugs adverse effects [p > 0.8] while revealed significant effects of recovered side effects [p < 0.01]. The common adverse effects of lFN beta that were significantly found [p < 0.01], are flu-like symptoms, fatigue, chills and fever, injection site pain and local redness, headache, irregular menses and mild depression specially with IFN beta-la intramuscular. No difference in the clinical suspicions of binding antibodies development to beta-IFNs was found. On the whole, all groups showed significant reduction of relapse frequency and MRI load with different values [p < 0.01]. In summary, this study does make available meaningful and helpful clinical and radiological data to the clinician regarding the relative efficacy of each therapy in RRMS. First, the results of our study suggest that IFN beta-lb 8MU and IFN beta-1a 44 micro g may be more optimal choices than IFN beta-la 30 micro g Intramuscular and IFN beta-la 22 micro g at the currently available dose in treatment of RRMS patients. Secondly, the results do not differ from remarks made after 18 months of treatment in larger and more rigorously controlled studies. Thirdly, therapy does construct a difference and early treatment should be encouraged