The following article is part of conference coverage from the 2018 Annual Meeting of the Consortium of Multiple Sclerosis Centers in Nashville, Tennesssee. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from CMSC 2018.

Of patients with multiple sclerosis (MS) and breakthrough disease who switched from standard-dose intramuscular interferon beta-1a (IM IFNβ-1a) to IM IFNβ-1a administered twice a week, 50% experienced no breakthrough disease for 14 months or longer (14-192 months), according to research presented at the 32nd Annual Meeting of the Consortium of Multiple Sclerosis Centers, held May 30-June 2, 2018 in Nashville, Tennessee.

This observational retrospective study conducted from 1995 to 2015 at the VA West Los Angeles Medical Center examined the effect of switching 59 out of 107 participants on once-weekly standard doses of IFNβ-1a to twice-weekly doses. All participants were diagnosed with MS with breakthrough disease as defined by ongoing clinical relapses, worsening neurologic examination or scores on the Kurtzke Expanded Disability Status Scale (EDSS), or new T2 enhanced lesions shown on magnetic resonance imaging of the brain. 

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Of the 59 participants, 52 were followed up with approximately every 4 months for at least 2 years after treatment. At each follow-up visit, subjects were assessed using EDSS, Functional Systems Scale, Incapacity Status Scale, and a proprietary neurologic examination. An annual magnetic resonance imaging of the brain was performed for most participants. Half of the 52 participants who had adequate follow-up showed no further breakthrough disease for at least 14 months after treatment (range, 14-192 months). Of the 27 subjects who did not show this improvement, 5 could not tolerate the twice-weekly increase. Subjects who had remained stable on once-weekly IFNβ-1a for a long duration, subjects who had a higher EDSS score when switched, and African-American subjects were less likely to respond.

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The study investigator concluded, “For MS patients having breakthrough disease on standard-dose IM IFNβ-1a, switching to a more frequently administered IFNβ may be an option. Advantages to using an IM IFNβ preparation for this include no skin reactions and a lower incidence of interferon neutralizing antibodies. A prospective, blinded, randomized trial comparing once-weekly and twice-weekly IM IFNβ-1a may be indicated.”

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Baumhefner RW. 17-Year experience of treating multiple sclerosis with intramuscular interferon beta-1a twice a week.  Presented at: 32nd Annual Meeting of the Consortium of Multiple Sclerosis Centers. May 30-June 2, 2018; Nashville, TN. Abstract DX04.