Interferon Treatment For Multiple Sclerosis

Multiple sclerosis is a progressive disease affecting the central nervous system, causing various forms of sensory and motor disturbances. It is a long term condition, in which symptoms can wax and wane. Relapses are common and progression of the disease may result in various complications. Interferon treatment may help slow the progression of multiple sclerosis and prolong intervals between relapses.

What is Multiple Sclerosis?

Multiple sclerosis (MS) is an autoimmune condition where the body attacks the myelin covering of its nerves and brain tissue. This results in inflammation and damage to these nervous system structures, resulting in disruption in nerve signals. These changes affect motor function, manifested as loss of balance and coordination, spasticity, and uncontrolled muscle movements. Loss of vision (usually in one eye) and fatigue are also common. Most patients have a relapsing remitting type of condition, where there are intervals with mild or no symptoms followed by sudden flare-ups. This can last for years and later deteriorate to a progressive condition. A less common type of disease features a progressive condition with no periods of remission.

Multiple sclerosis affects about 350,000 people in the US and 100,000 in the UK. Caucasians and women are more likely to be affected at an average age of 30, although children and elderly individuals may also get the disease.

The Role of Interferon in the Management of Multiple Sclerosis

There is no cure for MS and management of the disease focuses on relief of symptoms, reducing relapses, delaying progression and treating its complications. This involves the use of steroids, which may reduce inflammation and relieve its symptoms, disease modifying drugs, which can help delay progression of the disease, and specific medications to treat its complications.

Interferons are proteins naturally produced by the immune system, which help protect the body from certain diseases. Their ability to regulate the immune system has led scientists to make synthetic interferons, which may be used as disease-modifying drugs in the management of MS. 

The types of interferon-beta approved by the FDA are interferon beta-1a (Avonex, Rebif) and interferon beta-1b (Betaseron, Extavia). All types of interferon beta are given by injection either to the skin or to the muscle.

Research shows that interferon reduces the MS relapse rate by one-third over a two-year period. Magnetic resonance imaging (MRI) has shown that patients treated with high doses of beta-interferon have fewer lesions and less scarring on the brain than patients on lower doses or those given placebo treatment. Studies also show that treatment with interferon beta may reduce severity of symptoms and lower the chance of disability in patients who have relapsing remitting MS.

Read More: EndMS Set To Raise Millions For Finding Multiple Sclerosis Cure

Other studies show, however, that about 30% of MS patients do not respond to interferon treatment (non-responders), while some studies suggest that combining other disease-modifying drugs such as daclizumab, a monoclonal antibody, with interferon treatment may be more effective in reducing relapse rates than using interferon alone.

Side Effects Of Interferon-Beta Treatment For Multiple Sclerosis

Natural produced interferons produce flu-like symptoms as the body fights disease-causing microbes such as viruses and bacteria. Similarly, laboratory manufactured interferons stimulate the immune system and produce significant side effects such as fever, chills, headaches, fatigue, muscle aches and joint pains after injections. They may vary in severity for different patients, being somewhat debilitating for some. However, these symptoms may improve after several weeks of therapy. Mild pain relievers such as acetaminophen or ibuprofen may be taken to reduce these flu-like symptoms.

Although depression is common among patients with MS, interferon treatment may make their symptoms worse.

Other conditions that may accompany MS and become worse with interferon treatment include anxiety, sleeping and eating disorders. One must consult their doctor when symptoms last more than a couple of days.

Patients who are being treated with beta-interferons must also be monitored using blood tests, preferably every three months to watch out for untoward changes in liver, thyroid, and immune function. However, in most cases, abnormalities found in these tests are reversed when treatment is stopped or when doses are adjusted.

Other drawbacks of interferon therapy include the prohibitive cost of interferon injections. While some patients do not respond to treatment, in others, the effect of long term treatment diminishes as the body produces neutralizing antibodies that counter the effects of treatment. Long-term risks are not yet known. It is best to discuss with your doctor about the benefits, risks, cost and prognosis involved in treating MS with interferon.

The application of a cold compress prior to injection may provide a transient localized anesthetic effect, while post-injection warmth may palliate ensuing discomfort or edema. Topical corticosteroid preparations, such as hydrocortisone, may be beneficial in addressing localized pruritus or inflammatory responses.

Psychotherapeutic intervention and, if clinically indicated, pharmacotherapy with antidepressants or anxiolytics, can be of value. Moreover, peer support, facilitated through patient advocacy groups or structured support systems, offers invaluable empathetic and experiential insights.

For patients experiencing alopecia or hair thinning, it is prudent to advise a gentle trichological regimen and to eschew aggressive hair treatments. If significant hair changes are observed, referral to a dermatologist specializing in trichology may be warranted. A holistic approach to patient care, emphasizing balanced nutrition, structured physical activity, and adequate sleep hygiene, may bolster overall well-being and potentially attenuate some adversarial side effects.

The decision whether to take disease-modifying drugs such as interferon will depend on your decision, as well as the doctor's advice. Some experts recommend beginning interferon therapy early right after diagnosis, so as to prevent further damage to the nervous system and reduce the risk for relapses. However, other experts advise their patients to wait and see, especially those who have mild symptoms, since the cost and side effects of treatment may outweight its benefits.

Read More: Interferon As Adjuvant Therapy For Malignant Melanoma

Other Options for Treatment of MS

Because of the prohibitive cost and side effects of interferons, doctors also consider using other disease-modifying drugs to manage the disease. These include the use of glatiramer acetate (Copaxone), another FDA approved drug for reducing relapses in MS. Glatiramer is a synthetic protein mixture that resembles myelin, which blocks and reduces the immune system reaction to the nerve covering. A local skin reaction and other side effects such as chest pain, palpitations, shortness of breath, or anxiety may occur.

Oral medications such as fingolimod (Gilenya) and teriflunomide (Aubagio) have also been approved, but their long-term effects are not yet known.

Aside from these disease-modifying drugs, patients may also be given other medications to control their symptoms. These include pain relievers, anti-depressants, corticosteroids, anticonvulsants, antibiotics and vitamins. Walkers, physical therapy, foot braces, and other supportive therapy may be used as needed.