Takaisin

Interferons-beta versus glatiramer acetate for relapsing-remitting multiple sclerosis

Evidence Summaries for Current Care Guidelines
Sari Atula
5.2.2019

Level of evidence: A

The effects of beta-interferons and glatiramer acetate are similar in relapsing-remitting multiple sclerosis regarding clinical and magnetic resonance imaging (MRI) parameters during two to three years. However, beta-interferons limit more effectively the increase in MRI lesion burden as compared with glatiramer acetate.

A Cochrane review «La Mantia L, Di Pietrantonj C, Rovaris M ym. Inter...»1 included 6 RCTs with a total of 2904 participants with relapsing-remitting multiple sclerosis. They were randomly assigned to get either beta-interferons (IFNs, n=1704) or glatiramer acetate (GA, n=1200). All comparisons were direct. The treatment duration was three years for one study and two years for the other 4 RCTs while one study was stopped early (after one year). The IFNs analysed in comparison with GA were IFN-beta 1b 250 mcg (2 trials, n=933), IFN-beta 1a 44 mcg (3 trials, n=466) and IFN-beta 1a 30 mcg (2 trials, n=305). The primary outcome variables were number of participants with relapse or progression. Both therapies showed similar clinical efficacy at 24 months regarding the number of patients with relapse (RR 1.04, 95 % CI 0.87 to 1.24; 3 trials, n=2184) or progression (RR 1.11, 95 % CI 0.91 to 1.35; 3 trials, n=2169). However at 36 months, evidence from a single study suggests that relapse rates were higher in the group given IFNs than in the GA group (RR 1.40, 95 % CI 1.13 to 1.74, p=0.002). Secondary magnetic resonance imaging (MRI) outcomes analysis showed that effects on new or enlarging T2- or gadolinium (Gd)-enhancing lesions at 24 months were similar (MD -0.15, 95 % CI -0.68 to 0.39; 3 trials, n=1790 and MD -0.14, 95 % CI -0.30 to 0.02; 3 trials, n=1734, respectively). However, the reduction in T2- and T1-weighted lesion volume was significantly greater in the groups given IFNs than in the GA groups at 24 months (MD -0.58, 95 % CI -0.99 to -0.18, p= 0.004; 2 trials, n=1608 and MD -0.20, 95 % CI -0.33 to -0.07, p= 0.003; 2 trials, n=1602, respectively). The number of participants who dropped out of the study because of adverse events was similar in the two groups (RR 0.95, 95 % CI 0.64 to 1.40).

References

  1. La Mantia L, Di Pietrantonj C, Rovaris M ym. Interferons-beta versus glatiramer acetate for relapsing-remitting multiple sclerosis. Cochrane Database Syst Rev 2016;11():CD009333. «PMID: 27880972»PubMed