Interferon therapy in relapsing-remitting multiple sclerosis: A systematic review and meta-analysis of the comparative trials

Oliver, Brant; Kohli, Erol; Kasper, Lloyd H.

doi:10.1016/j.jns.2010.11.003

Cited by 38 publications

(24 citation statements)

References 14 publications

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“…Authentic, five years study indicates that patients, who were treated with steroids or interferon therapy, had better life quality and prolonged remitting-relapse status . 14 This finding corresponds to the dates from other authors. 15 Retrobulbar neuritis is among the first signs of the multiple sclerosis.…”

Section: Discussionsupporting

confidence: 89%

Treatment of retrobulbar neuritis in multiple sclerosis with corticosteroids and interferon β1b

Janicijevic-Petrovic¹,

Sarenac-Vulovic²,

Janićijević³

et al. 2013

PONS

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Objective. Retrobulbar neuritis is the inflammation of optical nerve which is localized behind the eye. Patients with multiple sclerosis are adequate for our examination, because of well-known association between these two diseases.Methods. The study included 64 patients, divided in 4 groups, during last five years, during hospitalizations and outpatient controls. We analyzed demographic characteristics, neuro-ophthalmological clinical symptoms, diagnostic tests and the effectiveness of therapy.Results. The greatest number of patients was young women, from urban regions, treated primarily during the winter time of the year. Temporal pallor of optic head was always present in clinical status. The loss of visual acuity appeared in 64%, MRI findings were positive at 56%, positive cerebrospinal fluid findings were at 43% subjects. VEP examination was positive at 84%, ocular sequels at 67% and neurological disturbances occurred in 48% subjects. Incidence of relapse of retrobulbar neuritis was found in 16% of patients with normal MRI in the period of five years. After the treatment with corticosteroids, the appearance of plaques was delayed for 2 years at almost all patients. A good recovery of patients appeared after 2-3 weeks of corticosteroid treatment. The good results with interferon beta-1b therapy were achieved in 76% of patients. In our patients, prolongation of relapse-remitting status of retrobulbar neuritis during multiple sclerosis evolution was about 2 years.Conclusion. Retrobulbar neuritis is an important health problem in many patients suffering from multiple sclerosis.Key words: optic neuritis; multiple sclerosis; interferons. KORESPONDENCIJA / CORRESPONDENCEProf. dr Mirjana A. Janićijević-Petrović, Kneza Miloša 3/1-1, 34000 Kragujevac, Tel: 034370073, 066013691, E-mail: mira.andreja@yahoo.com Lečenje retrobulbarnog neuritisa u sklopu multiple skleroze kortikosteroidima i interferonom β1b APSTRAKT Cilj. Retrobulbarni neuritis je zapaljenje očnog nerva koje se lokalizuje iza očne jabučice. Pacijenti sa multiplom sklerozom su adekvatni za naše ispitivanje, zbog dobro poznate povezanosti ove dve bolesti.Metode. U studiju je uključeno 64 pacijenta, podeljenih u 4 grupe, poslednjih 5 godina, tokom hospitalizacija i ambulantnih kontrola. Analizirali smo demografske karakteristike, neurooftalmološku kliničku simptomatolugiju, dijagnostičke testove i efektivnost lečenja.Rezultati. Najveći broj pacijenata su bile mlađe žene, urbanih regiona, lečene preteženo u zimskom periodu kalendarske godine. Temporalno bledilo glave optičkog živca bio je uvek prisutan klinicki status. Pad vidne oštrine zabeležen je kod 64% ispitanika, pozitivan MRI nalaz nađen je kod 56%, a pozitivan nalaz u likvoru kod 43% ispitanika. Pozitivan VEP -nalaz bio je kod 84%, očne sekvele kod 67%, a neurološki poremećaji kod 48% ispitanika. Incidenca recidiva retrobulbarnog neuritisa zabeležena je kod 16% pacijenata sa normalnim MRI nalazom tokom pet godina. Nakon kortikosteroidnog tretmana pojava plakova bila je odložena za oko 2 godin...

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Section: Discussionsupporting

confidence: 89%

Treatment of retrobulbar neuritis in multiple sclerosis with corticosteroids and interferon β1b

Janicijevic-Petrovic¹,

Sarenac-Vulovic²,

Janićijević³

et al. 2013

PONS

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“…A systematic review of head to head RCTs concluded that high dose interferon beta formulations are superior for relapse control and MRI effects but not for disability outcomes. 56 Neutralizing antibodies against interferon beta abrogate treatment benefits. 57 58 Greater injection frequency contributes to non-adherence.…”

Section: Background and Rationale For Disease Modifying Therapiesmentioning

confidence: 99%

Disease modifying therapies for relapsing multiple sclerosis

Wingerchuk

Weinshenker

2016

BMJ

144

116

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Multiple sclerosis (MS) is a common, disabling, putatively autoimmune neurological disease with worldwide distribution. It typically begins as a relapsing disorder that later evolves to a secondary progressive phase. Inflammatory and neurodegenerative mechanisms seem to operate in both phases, but their relative contributions and interactions are incompletely understood. Disease modifying therapies (DMTs) approved for relapsing multiple sclerosis interfere with a variety of immunological mechanisms to reduce rates of relapse, accumulation of disease burden measured by magnetic resonance imaging (MRI), and decline in neurological function over the two to three year duration of typical randomized controlled trials. Benefits of longer duration of therapy on disability are less clear, as data beyond three years are largely limited to observational studies. However, current DMTs do not slow accrual of disability once progressive multiple sclerosis is established. This review summarizes the evidence about the use of approved DMTs and examines how to individualize treatment despite the absence of validated biomarkers to guide drug selection. Methods such as stratifying patients on the basis of estimated risk for future disability, weighing patient specific factors and preferences, and using objective outcomes to adjudicate treatment success are discussed. Emerging drug therapies and strategies are also reviewed.

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“…The clinical efficacy in comparative randomized trials is summarized in Table 3. Meta-analyses show that IFNβ is associated with a significant effect on MS relapses and disability progression compared with placebo [38, 39]; however, the effect of IFNβ therapy on disability progression has been disputed, as a large-scale, retrospective study of prospectively collected data demonstrated that IFNβ was not associated with a reduction in disability progression [35–37]. A consideration relating to the efficacy of the IFNβ formulations is the potential for patients to produce neutralizing antibodies.…”

Section: Parenteral Therapiesmentioning

confidence: 99%

Immunological Mechanism of Action and Clinical Profile of Disease-Modifying Treatments in Multiple Sclerosis

2014

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Multiple sclerosis (MS) is a life-long, potentially debilitating disease of the central nervous system (CNS). MS is considered to be an immune-mediated disease, and the presence of autoreactive peripheral lymphocytes in CNS compartments is believed to be critical in the process of demyelination and tissue damage in MS. Although MS is not currently a curable disease, several disease-modifying therapies (DMTs) are now available, or are in development. These DMTs are all thought to primarily suppress autoimmune activity within the CNS. Each therapy has its own mechanism of action (MoA) and, as a consequence, each has a different efficacy and safety profile. Neurologists can now select therapies on a more individual, patient-tailored basis, with the aim of maximizing potential for long-term efficacy without interruptions in treatment. The MoA and clinical profile of MS therapies are important considerations when making that choice or when switching therapies due to suboptimal disease response. This article therefore reviews the known and putative immunological MoAs alongside a summary of the clinical profile of therapies approved for relapsing forms of MS, and those in late-stage development, based on published data from pivotal randomized, controlled trials.

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Interferon therapy in relapsing-remitting multiple sclerosis: A systematic review and meta-analysis of the comparative trials

Cited by 38 publications

References 14 publications

Treatment of retrobulbar neuritis in multiple sclerosis with corticosteroids and interferon β1b

Treatment of retrobulbar neuritis in multiple sclerosis with corticosteroids and interferon β1b

Disease modifying therapies for relapsing multiple sclerosis

Immunological Mechanism of Action and Clinical Profile of Disease-Modifying Treatments in Multiple Sclerosis

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