Source: DGNews  |  Posted 3 years ago

By Andrew N. Wilner, MD

SALT LAKE CITY, Utah -- September 24, 2008 -- The different disease-modifying drugs available on the market for treatment of relapsing-remitting multiple sclerosis (MS) result in similar rates of disease relapse when examined over the long term, according to a retrospective chart review.

Loren Rolak, MD, The Marshfield Clinic, Marshfield, Wisconsin, presented the results of the study here on September 23 at the American Neurological Association (ANA) 133rd Annual Meeting.

Dr. Rolak and colleagues reviewed the clinical course of 573 patients with relapsing-remitting MS treated with disease modifying agents at The Marshfield Clinic. They evaluated 176 patients for >5 years, 47 patients for >10 years, and 27 patients for >12 years.

Results show that relapse rates (RR) were similar among the 4 disease-modifying therapies: 0.29 with glatiramer acetate subcutaneous (n = 224), 0.32 with beta interferon-1a intramuscular (n = 180), 0.30 with beta interferon -1a subcutaneous (n = 43), and 0.31 with beta interferon-1b subcutaneous (n = 126).

There was no association between major histocompatibility complex class II DR beta 1 (HLA-DRB1) or nitric oxide synthase (NOS2A) genotypes and relapse rate among the different drugs.

"Switching to another drug doesn't matter in terms of relapses; if you fail one drug, switching to another one doesn't result in clinical improvement," Dr. Rolak added.

Dr. Rolak's data also demonstrated similar degrees of disability for patients on the different treatments during follow-up that extended to 12 years. At the onset of follow-up, patients had an Extended Disability Status Scale (EDSS) scores ranging from 1.5 to 2.5. At the end of 12 years, the EDSS scores ranged from 4 to 4.5. EDSS scores with the different drugs were similar at 7, 10, and 12 years.

These results are consistent with recent head-to-head trials that compared these drugs, Dr. Rolak observed. These studies failed to show significant differences in the efficacy of these drugs, he said.

"None of the drugs demonstrate superiority in relapse rate or EDSS when followed for up to 12 years," Dr. Rolak concluded.

[Presentation title: No Difference Among Disease-Modifying Drugs for the Long-Term Treatment of Multiple Sclerosis. Abstract T-103]