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Enhanced benefit of increasing interferon beta-1a dose and frequency in relapsing multiple sclerosis - The EVIDENCE study

Schwid, SR ; Thorpe, J ; Sharief, M ; Sandberg Wollheim, Magnhild LU ; Rammohan, K ; Wendt, J ; Panitch, H ; Goodin, D ; Li, D and Chang, P , et al. (2005) In Archives of Neurology 62(5). p.785-792
Abstract
Background: The EVIDENCE (Evidence of Interferon Dose-Response: European North American Comparative Efficacy) Study demonstrated that patients with multiple sclerosis (MS) who initiate interferon beta-la therapy with 44 μ g 3 times weekly (TIW) were less likely to have a relapse or activity on magnetic resonance imaging (MRI) compared with those who initiate therapy at a dosage of 30 μ g 1 time weekly (QW). Objective: To determine the effect of changing the dosage from 30 μ g QW to 44 μ g TIW in this extension of the EVIDENCE StudyDesign/Patients: Patients with relapsing MS originally randomized to interferon beta-1a, 30 μ g QW, during the comparative phase of the study changed to 44 μ g TIW, whereas patients originally randomized to 44 μ... (More)
Background: The EVIDENCE (Evidence of Interferon Dose-Response: European North American Comparative Efficacy) Study demonstrated that patients with multiple sclerosis (MS) who initiate interferon beta-la therapy with 44 μ g 3 times weekly (TIW) were less likely to have a relapse or activity on magnetic resonance imaging (MRI) compared with those who initiate therapy at a dosage of 30 μ g 1 time weekly (QW). Objective: To determine the effect of changing the dosage from 30 μ g QW to 44 μ g TIW in this extension of the EVIDENCE StudyDesign/Patients: Patients with relapsing MS originally randomized to interferon beta-1a, 30 μ g QW, during the comparative phase of the study changed to 44 μ g TIW, whereas patients originally randomized to 44 μ g TIW continued that regimen. Patients were followed up, on average, for an additional 32 weeks. Main Outcome Measure: The within-patient pretransition to posttransition change in relapse rate. Results: At the transition visit, 223 (73%) of 306 patients receiving 30 μ g QW converted to 44 μ g TIW, and 272 (91%) of 299 receiving 44-μ g TIW continued the same therapy. The posttransition annualized relapse rate decreased from 0.64 to 0.32 for patients increasing the dose (P<.001) and from 0.46 to 0.34 for patients continuing 44-μ g TIW (P =.03). The change was greater in those increasing dose and frequency (P=.047). Patients converting to the 44-μ g,TIW regimen had fewer active lesions on T2-weighted MRI compared with-before the transition (P=.02), whereas those continuing the 44-μ g TIW regimen had no significant change in T2 active lesions. Patients who converted to high-dose/high-frequency interferon beta-la therapy had increased rates of adverse events and treatment terminations consistent with the initiation of high-dose subcutaneous interferon therapy. Conclusions: Patients receiving interferon beta-la improved on clinical and MRI disease measures when they changed from 30μ g QW to 44 μ g TIW. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Archives of Neurology
volume
62
issue
5
pages
785 - 792
publisher
American Medical Association
external identifiers
  • pmid:15883267
  • wos:000229047700012
  • scopus:20844456591
ISSN
0003-9942
language
English
LU publication?
yes
id
5277cc3a-dffa-46b6-ac8b-c6858f740b16 (old id 240649)
alternative location
http://archneur.ama-assn.org/cgi/content/full/62/5/785
date added to LUP
2016-04-01 12:05:47
date last changed
2021-10-06 02:34:21
@article{5277cc3a-dffa-46b6-ac8b-c6858f740b16,
  abstract     = {Background: The EVIDENCE (Evidence of Interferon Dose-Response: European North American Comparative Efficacy) Study demonstrated that patients with multiple sclerosis (MS) who initiate interferon beta-la therapy with 44 μ g 3 times weekly (TIW) were less likely to have a relapse or activity on magnetic resonance imaging (MRI) compared with those who initiate therapy at a dosage of 30 μ g 1 time weekly (QW). Objective: To determine the effect of changing the dosage from 30 μ g QW to 44 μ g TIW in this extension of the EVIDENCE StudyDesign/Patients: Patients with relapsing MS originally randomized to interferon beta-1a, 30 μ g QW, during the comparative phase of the study changed to 44 μ g TIW, whereas patients originally randomized to 44 μ g TIW continued that regimen. Patients were followed up, on average, for an additional 32 weeks. Main Outcome Measure: The within-patient pretransition to posttransition change in relapse rate. Results: At the transition visit, 223 (73%) of 306 patients receiving 30 μ g QW converted to 44 μ g TIW, and 272 (91%) of 299 receiving 44-μ g TIW continued the same therapy. The posttransition annualized relapse rate decreased from 0.64 to 0.32 for patients increasing the dose (P&lt;.001) and from 0.46 to 0.34 for patients continuing 44-μ g TIW (P =.03). The change was greater in those increasing dose and frequency (P=.047). Patients converting to the 44-μ g,TIW regimen had fewer active lesions on T2-weighted MRI compared with-before the transition (P=.02), whereas those continuing the 44-μ g TIW regimen had no significant change in T2 active lesions. Patients who converted to high-dose/high-frequency interferon beta-la therapy had increased rates of adverse events and treatment terminations consistent with the initiation of high-dose subcutaneous interferon therapy. Conclusions: Patients receiving interferon beta-la improved on clinical and MRI disease measures when they changed from 30μ g QW to 44 μ g TIW.},
  author       = {Schwid, SR and Thorpe, J and Sharief, M and Sandberg Wollheim, Magnhild and Rammohan, K and Wendt, J and Panitch, H and Goodin, D and Li, D and Chang, P and Francis, G},
  issn         = {0003-9942},
  language     = {eng},
  number       = {5},
  pages        = {785--792},
  publisher    = {American Medical Association},
  series       = {Archives of Neurology},
  title        = {Enhanced benefit of increasing interferon beta-1a dose and frequency in relapsing multiple sclerosis - The EVIDENCE study},
  url          = {http://archneur.ama-assn.org/cgi/content/full/62/5/785},
  volume       = {62},
  year         = {2005},
}