Interferon β for secondary progressive multiple sclerosis: a systematic review
- Loredana La Mantia1,
- Laura Vacchi2,
- Marco Rovaris1,
- Carlo Di Pietrantonj3,
- George Ebers4,
- Sten Fredrikson5,
- Graziella Filippini2
- 1Neurorehabilitation Unit, Multiple Sclerosis Centre, IRCCS S Maria Nascente Fondazione Don Gnocchi, Milano, Italy
- 2Neuroepidemiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
- 3Regional Reference Centre for Epidemiology, Cochrane Vaccines Field, Local Health Unit, Alessandria, Italy
- 4Clinical Neurology, University of Oxford, Oxford, UK
- 5Division of Neurology R54, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Correspondence to Dr L La Mantia, Multiple Sclerosis Centre, Neurorehabilitation Unit, IRCCS Santa Maria Nascente Fondazione Don Gnocchi, Via Capecelatro 66, I-20148 Milano, Italy;
Contributors The study protocol was designed by GF, LLM, GE and SF; study selection and data extraction were performed by GF, LLM and LV; analyses were carried out by GF, LLM, LV and CDP; all authors contributed to the interpretation of the statistical analyses, writing and revision of the paper.
- Received 26 May 2012
- Revised 7 August 2012
- Accepted 10 August 2012
- Published Online First 5 September 2012
Background It is unclear whether recombinant β interferons (IFNβ) can be effective in secondary progressive multiple sclerosis (SPMS). The aim was to determine whether IFNβ can reduce the risk of disability and cognitive impairment progression in SPMS.
Methods Using Cochrane methodology, we reviewed all randomised placebo controlled trials of IFNβ in SPMS patients (1995–March 2012).
Results 5 trials (3082 patients) were included. After 3 years, interferons did not reduce disability progression, confirmed at 6 months (RR 0.98, 95% CI 0.82 to 1.16). A small reduction in the number of patients who had relapses during the first 3 years of treatment (RR 0.91, 0.84 to 0.97) was found. No analysis of cognitive data was possible. More treated than placebo patients dropped out for adverse events.
Conclusion 3 year treatment with IFNβ does not delay permanent disability in SPMS but reduces relapse risk, indicating that the anti-inflammatory effect of IFNβ is unable to prevent MS progression once it has become established.
Competing interests LLM has participated in clinical trials sponsored by Schering and meetings sponsored by Schering, Bayer, Merck Serono and Biogen Idec. SF has received honoraria for lectures and educational activities sponsored by Bayer Schering Pharma, Biogen Idec and Merck Serono; he participated as an investigator in the European SG. MR has received honoraria for lectures and educational activities sponsored by Biogen Idec.
Provenance and peer review Not commissioned; externally peer reviewed.