|
|
|
|
To determine which patients are prone to side effects from interferon beta-1b and which side effects are most troublesome,we studied 72 patients with clinically definite MS who were started on interferon beta-1b after its release and found that the side effects significantly associated with treatment included skin reactions,flu-like symptoms,fatigue,leukopenia,new or worsened depression,and new or worsened headache.Of these,only fatigue and depression were significantly associated with discontinuance of therapy.Moreover,the course of disease before initiation of treatment also had a significant impact on the likelihood of discontinuing medication. Thus,despite an apparently similar therapeutic benefit(as judged by the similarly reduced attack rate in each group),patients with a secondary chronic progressive course were more likely to discontinue treatment(63%) than patients with either a relapsing/progressive course(18%)or a remitting/relapsing course(7%).Indeed,in the final regression equation,the only factors significantly related(r=0.875)to the discontinuance of therapy were fatigue(p<0.0001),a fatigue-depression interaction(p<0.0001). Thus,if future clinical trials are to provide useful information on the value of interferon beta-1b in progressive MS,the side effects of fatigue and depression will need to be ameliorated to limit the drop-out rate from such trials. |
|