Therapeutic effect of Avonex, Rebif and Betaferon on quality of life in multiple sclerosis

Abstract

Aims:The aim of this study was to evaluate the effect of various disease-modifying therapies (DMT) on quality of life in multiple sclerosis (MS).Methods: This was a three-arm parallel study with balanced randomization in which 90 newly diagnosed, definite MS subjects referred to Ghaem Medical Center, Mashhad, Iran were enrolled between 2006 and 2009. Patients were randomly allocated into three DMT groups: Avonex, Rebif and Betaferon. Health-related quality of life was assessed in MS patients at baseline and 12 months after treatment with DMT using the MS Quality of Life-54 questionnaire.Results: Both mental and physical health scores improved within all three treatment groups after 12 months of treatment; however, this increase was only significant in the mental health composite in the Betaferon group (P = 0.024). Betaferon had the highest mental health score change (14.04) while this change was 7.26 for Avonex (P = 0.031) and 5.08 for Rebif (P = 0.017). A physical health composite score comparison among the three treatment groups revealed no significant results. Conclusions:With a positive impact of DMT on mental and physical dimensions of QOL in MS patients, initiation of treatment soon after diagnosis is recommended. In MS patients with more mental issues and fewer physical disabilities, Betaferon might be considered as a better choice of treatment.Key words: disease-modifying therapies, multiple sclerosis, quality of life. M ULTIPLE SCLEROSIS (MS) is the most common demyelinating disorder of the central nervous system that usually affects young adults.1 The disease is characterized by multifocal, inflammatory, and immune-mediated central nervous system injury, which can cause a variety of symptoms and consequently requires comprehensive medical care. [2][3][4] MS, as a long-term illness, can result not only in physical disabilities, but also in substantial mental health problems influencing the quality of life (QOL) of patients, their partners, families, and caregivers. 5-7The health-related QOL, or the capacity to derive satisfaction from meaningful behavior despite disease, is a topic of increasing interest to clinicians caring for MS patients. Hence in patients with MS, apart from complete psychophysical and objective neurologic status, a subjective perception of signs and symptoms, known as QOL, needs to be considered. Disease-modifying therapies (DMT) have a beneficial effect on the course of MS in terms of reducing the relapse rates and delaying the onset and progression of disabilities. [12][13][14][15][16][17] In spite of limited data on QOL and its correlation with DMT, it is possible that DMT influence the QOL, independent of the physical disabilities.18 As treatment with β-interferon (IFN-β) is a life-long treatment and patients often experience various side-effects, a positive effect on the patient's QOL is critical. [12][13][14]19 Therefore, this study investigates the effect of DMT (IFN-β-1a [Avonex and Rebif] and IFN-β-1b [Betaferon]) on QOL in a group of MS patients. METHODS Study designThe c...

Clinical effectiveness and cost-effectiveness of beta-interferon and glatiramer acetate for treating multiple sclerosis: systematic review and economic evaluation

“…A pairwise significance test was not performed. Patients in the study by Mokhber et al 186,187 in both treatment groups also showed a decrease in EDSS score, but in the opposite direction (44 µg: -1.0, p = 0.001; 250 µg: -0.6, p = 0.028). Again, a pairwise significance test was not performed.…”

“…[174][175][186][187][188][189][190][191][192][195][196][197][198][199][200]213,216,[219][220][222][223][224] Studies that reported methods of allocation concealment (the concealment of study allocation before the beginning of assigned treatment) were also judged to be at low risk of bias (n = 22/35), 171,[174][175]181,[188][189][190][191][195][196][198][199]207,213,[216][217][219][220][221][222][223][224] with the exception of one study that used open allocation. 170 All studies citing central allocation were judged as having a low risk of bias.…”

“…Again, formal pairwise significance testing was not reported. Moreover, in a comparatively small trial, Mokhber et al 186,187 found no evidence of a significant difference in EDSS score between baseline and 12 months' follow-up for 30 µg of IM IFN-β-1a once a week (0.0, n = 20; p = 0.548), whereas a test for change was significant for 250 µg of SC IFN-β-1b every other day (-0.6, n = 19; p = 0.028). Pairwise testing was not performed but an overall test was not significant.…”

“…Of the 24 trials reporting clinical outcomes, four trials had three relevant treatment arms: An additional six trials compared 30 µg of IM IFN-β-1a once a week against other drugs: three multiarm trials [185][186][187][188] and three two-arm trials. 191,[193][194][195][196] Relapse outcomes…”

“…An additional six trials compared 44 µg of SC IFN-β-1a three times a week against other drugs: three multiarm trials [185][186][187][188] and three two-arm trials. [192][193][194][195]197 Comparisons in the EVIDENCE trial [193][194][195] were discussed earlier.…”