Clinical effects and tolerability of high-dose, high-frequency recombinant interferon beta-1a in patients with multiple sclerosis: maximizing therapy through long-term adherence.
BACKGROUND
High-dose, high-frequency IFN beta-1a in multiple sclerosis (MS) can prevent lesion formation, decrease the frequency/severity of relapses and delay progression of disability, with a proven safety profile. Rates of non-adherence are high. There are drugs under investigation that may have greater efficacy and different safety profiles from existing therapies.


METHODS
Evidence supporting the efficacy of IFN beta-1a, factors contributing to non-adherence, and strategies to combat non-adherence. It is hoped that these strategies, coupled with future advances in pharmacogenetics, might lead to better outcomes. The PubMed database was searched using the terms "multiple sclerosis" and "interferon beta-1a", for papers published between 1998 and 2010. Relevant manuscripts and pivotal papers from clinical trials were cited. Searches of abstracts from congresses were also performed to obtain recent findings.


RESULTS
An overview of early pivotal trials, comparative studies with other treatments, and recent studies assessing the development of this therapy.


CONCLUSIONS
Long-term treatment with IFN beta-1a has benefits in MS and a good safety profile. Although adherence outside of clinical trials can be poor, injection devices, better tolerated drug formulations and education regarding treatment expectations are some of the strategies employed to help patients to adhere to treatment in the hope of improving outcomes.
Boyko
Alexey N
AN
Russian State Medical University, City Hospital #11, Department of Neurology and Neurosurgery, Dvitsev 6, 127018 Moscow, Russia. boykoa13@gmail.com
D018849:Controlled Clinical Trials as Topic; D006801:Humans; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000009:adverse effects / Q000627:therapeutic use*; D009103:Multiple Sclerosis / Q000628:therapy*; D010349:Patient Compliance; D010919:Placebos; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use
D010919:Placebos; D011994:Recombinant Proteins; D016899:Interferon-beta; D000068556:Interferon beta-1a