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Interferon beta in multiple sclerosis: experience in a British specialist multiple sclerosis centre
  1. B D Dubois,
  2. E Keenan,
  3. B E Porter,
  4. R Kapoor,
  5. P Rudge,
  6. A J Thompson,
  7. D H Miller,
  8. G Giovannoni
  1. Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
  1. Correspondence to:
 Dr G Giovannoni, Department of Neuroinflammation, Institute of Neurology, Queen Square, London WC1N 3BG, UK;


Background: The efficacy of interferon beta (IFN beta) is well established in relapsing-remitting multiple sclerosis (MS). However, the use of this drug in clinical practice is complex, especially because it is only partially effective, its long term efficacy and side effects are unknown, its efficacy may be abrogated by the development of neutralising antibodies, compliance is variable, and its cost effectiveness is controversial.

Objectives and Methods: Analysis of a prospectively followed up series of 101 MS patients treated with IFN beta was undertaken to: (1) monitor the outcome of IFN beta treatment in clinical practice; (2) compare the immunogenicity of the three commercial IFN beta preparations available; (3) assess the proportion of patients fulfilling the current guidelines of the Association of British Neurologists for stopping IFN beta therapy.

Results: During a median treatment period of 26 months (range 2–85), the relapse rate decreased by 41%. Although the reduction in the relapse rate was similar for all three commercial products, none of the Avonex treated patients were relapse free, compared with 19% of the Betaferon treated and 27% of the Rebif treated patients (p=0.02). Neutralising antibodies were not detected in Avonex treated patients (0 of 18), compared with 12 of 32 (38%) Betaferon treated and 10 of 23 (44%) Rebif treated patients (p=0.02). Forty of 101 (40%) patients satisfied the current (2001) Association of British Neurologists criteria for stopping IFN beta treatment at some stage during their treatment.

Conclusion: IFN beta is effective in reducing the relapse rate in patients with relapsing-remitting MS in routine clinical practice. However, after a median treatment duration of 26 months, 40% of initially relapsing-remitting MS patients seem to have ongoing disease activity, presenting as disabling relapses or insidious progression.

  • multiple sclerosis
  • interferon beta
  • neutralising antibodies
  • IFN beta, interferon beta
  • MS, multiple sclerosis
  • NAB, neutralising antibody
  • EDSS, Expanded Disability Status Scale
  • ABN, Association of British Neurologists

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  • Competing interests: DB, EK, BP, PR, RK, AJT, DHM, and GG have participated in meetings sponsored by, and received honorariums from, pharmaceutical companies marketing treatments for multiple sclerosis; our departments have received financial support for participation in randomised controlled trials of IFNbeta-1b, IFNbeta-1a and copaxone in multiple sclerosis (Schering, Biogen, and Teva); PR, DHM, and GG have received honorariums for acting in an ad hoc capacity as advisors to various pharmaceutical companies who have drug development programmes for multiple sclerosis.