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A recombinant form of interferon beta-1b(Betaseron)was given Food and Drug administration approval for use in the treatment of relapsing-remitting multiple sclerosis in 1993 base on a documented reduction in exacerbation rate.However,its effect on disease progression is less clear.It costs$ 11000 per year and has documented adverse effects such as fatigue, feverlike symptoms,and depression.Over the 12 month of follow-up,the case patients reported 10.6 months of quality-adjusted time,while the control patients reported 10.4 months of quality-adjusted time(P=.50).Thus,the first year of treatment with interferon beta-1b did not significantly improve or detract from QOL.Results are discussed in terms of acceptable trade-offs depending on the nature of the therapy.Future observational and clinical studies should incorporate measures of patient preference. |
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