Adding oral steroids to interferon beta-1a reduces relapse in MS

Two new studies suggest that the addition of oral methylprednisolone to subcutaneous interferon beta-1a (IFB1a) substantially reduces the relapse rate in patients with relapsing-remitting multiple sclerosis (RRMS). Published in Lancet Neurology, the first study (NORMIMS) analysed 130 patients with RRMS in 29 centres in Denmark, Norway, Sweden, and Finland. Each patient had at least one relapse in the previous 12 months despite receiving subcutaneous IFB1a three times a week. Patients were randomised to receive an add-on therapy of either 200mg of oral MP (66 patients) or matching placebo (64) on five consecutive days, every four weeks for 96 weeks. The researchers found that a high number of patients had withdrawn from the study before week 96 (26% of MP group, 17% of placebo group) because of side-effects (treatment group) or lack of effect (placebo group). The mean yearly relapse rate was 22% in the MP group, versus 59% in the placebo group. Sleep disturbance and neurological and psychiatric symptoms were the most frequent side-effects recorded in the MP group. However, they noted that because of the small number of patients and the high dropout rate, the findings should be corroborated in larger cohorts. “Oral methoprednisolone as an add-on therapy to interferon beta could be an important alternative to more expensive and potentially more harmful therapies for patients with relapsing-remitting multiple sclerosis whose disease is insufficiently controlled by first-line therapies,” the authors concluded. The second study (MECOMBIN) presented at the American Academy of Neurology's 61st annual meeting showed a significant 38% reduction in the secondary end point of annualized disease activity in treatment-naive patients treated with monthly cycles of MP in addition to regular weekly treatment with IFNB-1a vs those treated with a combination IFNB-1a plus placebo....