By:  Dr. Armistead D.  Williams

A lot of our patients have asked about the recent study in the Journal of the American Medical Association that reports that beta interferons do not prevent disability.

Here’s our take:

This study has two important flaws. The first is that it compared people who took an interferon against a group of people who chose not to take interferon. This comparison group had mild MS for almost twice as long as the interferon group (5.6 versus 3 years). As the early years of their MS were milder, they were more likely to have a better outcome and to not want to take a medication. This stacks the deck against a fair comparison.

The group taking interferons tended to have a lower risk of disability than the “historical control group." This trend did not reach statistical significance, a point that leads to our second concern.

Our second concern with this study is that it presumes that all patients respond equally to interferon, which is not true in MS and is not true for many other diseases such as hypertension. When a patient starts any medication, the first and second questions are “Do you tolerate it?” and “Is it working?” In the real world, most MS specialists do not wait until a person is disabled to decide if the medication is working, they look at relapses and MRI changes. When we see our strategy isn’t working, we look at the other options. There are many for relapsing remitting MS. In this study, the interferon patients appear to have continued the medication indefinitely without mention of who was responding. This study is conspicuous in not mentioning the ongoing relapse rate or other markers of disease activity.

We believe that Beta interferons, and glatiramer acetate, are safe and continue to have an important role in MS therapy for appropriately selected patients.