Switching Patients With MS Who Are Stable on Interferon β Has Suboptimal Outcomes

Patients with multiple sclerosis (MS) who are stable on an interferon β (INFβ) should remain on that therapy rather than switching to another INFβ, according to a study in ClinicoEconomics and Outcomes Research.

Patients with relapsing-remitting MS (RRMS) can be treated with disease-modifying therapies (DMTs), which can limit the number of relapses and slow disease progression. Patients with RRMS on INFβ can be switched to another INFβ or an alternative DMT, but the outcomes had not been studied extensively, yet.

There are reasons to switch patients, the authors noted, such as when patients are experiencing intolerable side effects or if the patient is experiencing a suboptimal response. In comparison, switching patients for economic reasons can be harmful, they wrote.

“Increasingly, formulary changes by the patient’s insurer also may result in switching without a clinical or patient-related basis for the switch,” the authors noted.

The study included 1143 patients in a No Switch group (these patients stayed on the same INFβ) and 381 patients in a Switch group (these patients switched to a different INFβ). The Switch group had a higher proportion of patients experiencing a relapse rate (82% higher), and the annual relapse rate during the follow-up year was also significantly higher (75% higher) compared with the No Switch group.

“These findings support the benefits of allowing patients to remain on current INFβ therapy when stable,” the authors concluded. “Further studies are needed to better understand when to switch therapies vs staying on initial therapy for MS patients.”

Reference

Chen C, Wu N, Watson C. Multiple sclerosis patients who are stable on interferon therapy show better outcomes when staying on same therapy than patients who switch to another interferon. Clinicoecon Outcomes Res. 2018;10:723-730. doi: 10.2147/CEOR.S163907.