title: Beta-interferon exposure and onset of secondary progressive multiple sclerosis.
abstract: OBJECTIVE
  Beta-interferons (IFNβ) are the most widely prescribed drugs for patients with multiple sclerosis (MS). However, whether or not treatment with IFNβ can delay secondary progressive MS (SPMS) onset remains unknown. Our aim was to examine the association between IFNβ exposure and SPMS onset in patients with relapsing-remitting MS (RRMS).
  
  
  METHODS
  A retrospective cohort study using British Columbia (Canada) population-based clinical and health administrative data (1985-2008) was conducted. RRMS patients treated with IFNβ (n = 794) were compared with untreated contemporary (n = 933) and historical (n = 837) controls. Cohort entry was the first clinic visit during which patients became eligible for IFNβ treatment (baseline). The outcome was time from baseline to SPMS onset. Cox regression models with IFNβ as a time-dependent exposure were adjusted for sex, and baseline age, disease duration, disability, *socioeconomic status and *comorbidities (*available for the contemporary cohorts only). Additional analyses included propensity score adjustment.
  
  
  RESULTS
  The median follow-up for the IFNβ-treated, untreated contemporary and historical controls were 5.7, 3.7 and 7.3 years, and the proportions of patients reaching SPMS were 9.2%, 11.8% and 32.9%, respectively. After adjustment for confounders, IFNβ exposure was not associated with the risk of reaching SPMS when either the contemporary or the historical untreated cohorts were considered (hazard ratio 1.07; 95% confidence interval 0.93-1.48, and hazard ratio 1.04; 95% confidence interval 0.74-1.46, respectively). Further adjustments and the propensity score yielded results consistent with the main analysis.
  
  
  CONCLUSIONS
  Amongst patients with RRMS, use of IFNβ was not associated with a delayed onset of SPMS.
authors.affiliation: Division of Neurology and Brain Research Centre, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Zhang
authors.forename: A
authors.initials: A
authors.lastname: Shirani
authors.forename: Y
authors.initials: Y
authors.lastname: Zhao
authors.forename: M E
authors.initials: ME
authors.lastname: Karim
authors.forename: P
authors.initials: P
authors.lastname: Gustafson
authors.forename: J
authors.initials: J
authors.lastname: Petkau
authors.forename: C
authors.initials: C
authors.lastname: Evans
authors.forename: E
authors.initials: E
authors.lastname: Kingwell
authors.forename: M
authors.initials: M
authors.lastname: van der Kop
authors.forename: F
authors.initials: F
authors.lastname: Zhu
authors.forename: J
authors.initials: J
authors.lastname: Oger
authors.forename: H
authors.initials: H
authors.lastname: Tremlett
mesh_terms: D000328:Adult; D001955:British Columbia; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016899:Interferon-beta / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000517:prevention & control*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*
chemical_list: D016899:Interferon-beta
keywords: beta-interferon; cohort study; multiple sclerosis; progression
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