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March 1989

Systemic Interferon Alfa in Multiple Sclerosis-Reply

Author Affiliations

Department of Neurology University of Maryland 22 S Greene St Baltimore, MD 21201

Arch Neurol. 1989;46(3):252. doi:10.1001/archneur.1989.00520390018008

In Reply.  —Weinshenker and Ebers correctly point out that the relapse rate in multiple sclerosis declines with time, and that historical controls in clinical trials should be regarded with suspicion. The rapid decline in relapse rate in their prospective study1 from 1.80 in the first year of illness to 0.55 in the second is impressive; however, comparison with the group of patients we treated with systemic interferon alfa is not entirely appropriate.My report of long-term patient follow-up2 was published to compare systemic with intrathecal interferon treatment, as the latter had been reported to produce a long lasting clinical effect by Jacobs et al.3 Our patients were specifically selected for their high relapse rate, and were not typical of the more heterogeneous group described by Weinshenker and Ebers. They had multiple sclerosis for three to 15 years (mean, 7.5 years), and their exacerbation rate was still 1.33 per year for the

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