VLADIMIRHACHINSKIMD, FRCPC, DSCMED
TWO IFNs have recently been approved in the United States and Europe for treatment of MS. Whether to use these drugs, which drugs to use, and how to use them remains controversial. Interferon β-1b (Betaseron, Berlex, Richmond, Calif) and IFN-β-1a (Avonex, Biogen, Cambridge, Mass) were approved based on independent trials using different methods and end points, but both support the effectiveness of IFNs as a class of drugs in the treatment of MS. The IFN-β-1b trial1 was designed to show the effect of IFN-β-1b on acute attacks in patients with MS, and the IFN-β-1a trial2 was designed to show the effect of IFN-β-1a on the physical disabilities of those patients. The course of MS extends through decades, leading to significant disability with progressive decline at varying rates. Clinical trials run for 2 to 3 years. Trial end points are indicators of the long-term benefits of the drug under review. The ultimate extent and duration of the benefit of the treatment may not be known for years, but delaying irreversible change, ie, disability, is of great importance to patients with MS.
Herndon RM, Jacobs L. Interferons Should Be Used to Treat Most Patients With MS. Arch Neurol. 1998;55(12):1581-1583. doi:10.1001/archneur.55.12.1581