Beta-interferon exposure and onset of secondary progressive multiple sclerosis

BC MS Clinic Neurologists

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background and purpose: Beta-interferons (IFNβ) are the most widely prescribed drugs for patients with multiple sclerosis (MS). However, whether or not treatment with IFNβ can delay secondary progressive MS (SPMS) onset remains unknown. Our aim was to examine the association between IFNβ exposure and SPMS onset in patients with relapsing-remitting MS (RRMS). Methods: A retrospective cohort study using British Columbia (Canada) population-based clinical and health administrative data (1985-2008) was conducted. RRMS patients treated with IFNβ (n = 794) were compared with untreated contemporary (n = 933) and historical (n = 837) controls. Cohort entry was the first clinic visit during which patients became eligible for IFNβ treatment (baseline). The outcome was time from baseline to SPMS onset. Cox regression models with IFNβ as a time-dependent exposure were adjusted for sex, and baseline age, disease duration, disability, *socioeconomic status and *comorbidities (*available for the contemporary cohorts only). Additional analyses included propensity score adjustment. Results: The median follow-up for the IFNβ-treated, untreated contemporary and historical controls were 5.7, 3.7 and 7.3 years, and the proportions of patients reaching SPMS were 9.2%, 11.8% and 32.9%, respectively. After adjustment for confounders, IFNβ exposure was not associated with the risk of reaching SPMS when either the contemporary or the historical untreated cohorts were considered (hazard ratio 1.07; 95% confidence interval 0.93-1.48, and hazard ratio 1.04; 95% confidence interval 0.74-1.46, respectively). Further adjustments and the propensity score yielded results consistent with the main analysis. Conclusions: Amongst patients with RRMS, use of IFNβ was not associated with a delayed onset of SPMS.

Original languageEnglish (US)
Pages (from-to)990-1000
Number of pages11
JournalEuropean Journal of Neurology
Volume22
Issue number6
DOIs
StatePublished - Jun 1 2015

Fingerprint

Chronic Progressive Multiple Sclerosis
Interferon-beta
Interferons
Propensity Score
Confidence Intervals
Relapsing-Remitting Multiple Sclerosis
British Columbia
Ambulatory Care
Proportional Hazards Models
Social Class
Multiple Sclerosis
Canada
Comorbidity
Cohort Studies
Retrospective Studies

Keywords

  • Beta-interferon
  • Cohort study
  • Multiple sclerosis
  • Progression

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Beta-interferon exposure and onset of secondary progressive multiple sclerosis. / BC MS Clinic Neurologists.

In: European Journal of Neurology, Vol. 22, No. 6, 01.06.2015, p. 990-1000.

Research output: Contribution to journalArticle

BC MS Clinic Neurologists. / Beta-interferon exposure and onset of secondary progressive multiple sclerosis. In: European Journal of Neurology. 2015 ; Vol. 22, No. 6. pp. 990-1000.
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title = "Beta-interferon exposure and onset of secondary progressive multiple sclerosis",
abstract = "Background and purpose: Beta-interferons (IFNβ) are the most widely prescribed drugs for patients with multiple sclerosis (MS). However, whether or not treatment with IFNβ can delay secondary progressive MS (SPMS) onset remains unknown. Our aim was to examine the association between IFNβ exposure and SPMS onset in patients with relapsing-remitting MS (RRMS). Methods: A retrospective cohort study using British Columbia (Canada) population-based clinical and health administrative data (1985-2008) was conducted. RRMS patients treated with IFNβ (n = 794) were compared with untreated contemporary (n = 933) and historical (n = 837) controls. Cohort entry was the first clinic visit during which patients became eligible for IFNβ treatment (baseline). The outcome was time from baseline to SPMS onset. Cox regression models with IFNβ as a time-dependent exposure were adjusted for sex, and baseline age, disease duration, disability, *socioeconomic status and *comorbidities (*available for the contemporary cohorts only). Additional analyses included propensity score adjustment. Results: The median follow-up for the IFNβ-treated, untreated contemporary and historical controls were 5.7, 3.7 and 7.3 years, and the proportions of patients reaching SPMS were 9.2{\%}, 11.8{\%} and 32.9{\%}, respectively. After adjustment for confounders, IFNβ exposure was not associated with the risk of reaching SPMS when either the contemporary or the historical untreated cohorts were considered (hazard ratio 1.07; 95{\%} confidence interval 0.93-1.48, and hazard ratio 1.04; 95{\%} confidence interval 0.74-1.46, respectively). Further adjustments and the propensity score yielded results consistent with the main analysis. Conclusions: Amongst patients with RRMS, use of IFNβ was not associated with a delayed onset of SPMS.",
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author = "{BC MS Clinic Neurologists} and T. Zhang and A. Shirani and Y. Zhao and Karim, {M. E.} and P. Gustafson and J. Petkau and C. Evans and E. Kingwell and {van der Kop}, M. and F. Zhu and J. Oger and H. Tremlett",
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AU - Zhang, T.

AU - Shirani, A.

AU - Zhao, Y.

AU - Karim, M. E.

AU - Gustafson, P.

AU - Petkau, J.

AU - Evans, C.

AU - Kingwell, E.

AU - van der Kop, M.

AU - Zhu, F.

AU - Oger, J.

AU - Tremlett, H.

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