This prospective, multicentre, international, observational, cohort study compared injection site pain (ISP) and injection site reactions (ISRS) between interferon beta-1b (IFNB-1b; Betaferon) 250 microg subcutaneously every other day and interferon beta-1a (IFNB-1a; Rebif) 44 microg subcutaneously three times weekly in patients with relapsing-remitting MS. Patients started treatment within 3 months before recruitment and were on full dose of therapy at inclusion. Patients self-injected IFNB and self-assessed ISP for 15 consecutive injections immediately, 30 and 60 min after injection, using a visual analogue scale diary. Study staff assessed ISRS. Of 445 patients (valid cases), approximately 90% used autoinjectors. More patients were pain-free at all timepoints with IFNB-1b than with IFNB-1a (eg, 30 min: 42.6% versus 19.7%; P<0.0001). The mean proportion of pain-free injections was greater for IFNB-1b (eg, 30 min: 79.0%) than for IFNB-1a (53.3%; P<0.0001). The proportion of patients without ISRS was greater for IFNB-1b (second visit 51.8% versus 33.8%; P<0.0001). Compared with IFNB-1a, more IFNB-1b patients either had no pain or their ISP had no influence on treatment satisfaction (76.9% versus 64.1%; P=0.006). The impact on tolerability and patient acceptability of any new IFNB product formulations would, however, have to be evaluated in comparative studies.

No abstract

Prolonged-release fampridine (fampridine PR) is a potassium channel blocker that improves conductivity of signal on demyelinated axons in central nervous system. Fampridine PR has been approved to improve speed of walking in patients with multiple sclerosis. This statement provides a brief summary of data on fampridine PR and recommendations on practical use of the medication in clinical practice, prediction, and evaluation of response to treatment and patient management.

No abstract

The pathophysiology of multiple sclerosis (MS) includes also the vascular abnormalities. Recent reports on changes in venous cerebrospinal outflow and the investigation of immunomodulatory properties of several vascular mediators on the molecular level have added new information to hypotheses on vascular pathology as determining factor in the pathophysiology of MS. We assessed changes in serum paraoxonase 1 (PON1) activities in MS patients and polymorphism of PON1 as a risk factor for MS. The main role of serum PON1 is hydrolysis of lipid peroxides and protection of lowdensity lipoprotein particles from oxidation. These events could play a role in lowering the risk of atherogenesis and vascular complications development in MS. There are controversial results about association of two main polymorphisms in paraoxonase coding region (PON1 55L/M, PON1 192Q/R) and risk of MS in different populations. Our results support studies that PON1 polymorphisms are probably not a risk factor of MS development.