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Multiple Sclerosis
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A single-center, randomized, double-blind, placebo-controlled study of interferon beta-1b on primary progressive and transitional multiple sclerosis

X. Montalban

Unitat de Neuroimmunologia Clínica, Multiple Sclerosis Centre of Catalonia (CEM-Cat), Barcelona, Spain, xavier.montalban{at}unic-em.com

J. Sastre-Garriga

Unitat de Neuroimmunologia Clínica, Multiple Sclerosis Centre of Catalonia (CEM-Cat), Barcelona, Spain

M. Tintoré

Unitat de Neuroimmunologia Clínica, Multiple Sclerosis Centre of Catalonia (CEM-Cat), Barcelona, Spain

L. Brieva

Unitat de Neuroimmunologia Clínica, Multiple Sclerosis Centre of Catalonia (CEM-Cat), Barcelona, Spain

FX Aymerich

Unitat de Ressonància Magnètica, Hospital Vall d'Hebron, Barcelona, Spain

J. Río

Unitat de Neuroimmunologia Clínica, Multiple Sclerosis Centre of Catalonia (CEM-Cat), Barcelona, Spain

J. Porcel

Unitat de Neuroimmunologia Clínica, Multiple Sclerosis Centre of Catalonia (CEM-Cat), Barcelona, Spain

C. Borràs

Unitat de Neuroimmunologia Clínica, Multiple Sclerosis Centre of Catalonia (CEM-Cat), Barcelona, Spain

C. Nos

Unitat de Neuroimmunologia Clínica, Multiple Sclerosis Centre of Catalonia (CEM-Cat), Barcelona, Spain

À. Rovira

Unitat de Ressonància Magnètica, Hospital Vall d'Hebron, Barcelona, Spain

Inflammation and neurodegeneration may have differential impacts on disease evolution in the different forms of multiple sclerosis. However, a beneficial effect of immunomodulatory drugs should not be ruled out in primary progressive multiple sclerosis. Our aim is to investigate the safety and efficacy of interferon beta-1b in primary progressive multiple sclerosis. We conducted a double-blind, stratified, randomized, parallel group, phase II pilot study where patients with primary progressive multiple sclerosis or ‘transitional’ forms of multiple sclerosis received interferon beta-1b at doses of 8 MIU or placebo for 24 months. The main objective of the study was to investigate the safety and tolerability of interferon beta-1b. The primary efficacy variable was the time to neurological deterioration (Expanded Disability Status Scale) confirmed at 3 months. Seventy-three patients were included and three dropped out the study. More patients in the treatment arm had at least one related adverse event (94.4% versus 45.9%; p < 0.001); no other significant differences in safety endpoints were observed. Time to neurological deterioration was not different between trial arms (log-rank test, p = 0.3135). Statistically significant differences favoring treatment were observed for the Multiple Sclerosis Functional Composite score at several timepoints, T1 and T2 lesion volume changes at 12 and 24 months, mean number of active lesions and proportion of patients with active lesions at 24 months. We conclude that interferon beta-1b is safe and well tolerated in patients with primary progressive multiple sclerosis and transitional multiple sclerosis. Positive effects of interferon beta on secondary clinical and magnetic resonance imaging outcomes were observed, but a beneficial effect on Expanded Disability Status Scale progression was not demonstrated.

Key Words: multiple sclerosis • clinical trial • interferon-beta • primary progressive • expanded disability status scale • multiple sclerosis functional composite

This version was published on October 1, 2009

Multiple Sclerosis, Vol. 15, No. 10, 1195-1205 (2009)
DOI: 10.1177/1352458509106937


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