A comparison of fatigue and cognition in relapsing-remitting MS patients receiving interferon medication

• Published in: Multiple sclerosis Vol. 14; p. S168
• Main Authors: Gramlich, C, Melanson, M, Doupe, M, Ruhlen, D, Wong, L, Bergen, K, Klowak, M, Namaka, M P
• Format: Journal Article
• Language: English
• Published: 01.09.2008
• ISSN: 1352-4585

Background: Interferon- beta (IFN- beta ) disease-modifying drugs reduce relapse rates and slow disease progression in relapsing-remitting multiple sclerosis (RRMS). Early treatment with these therapies may also prevent fatigue and slow cognitive decline. Objective: The goal of this study was to quantify the change in patient fatigue and/or cognitive status following the onset of treatment with IFN- beta therapy. Methods: A single center, phase IV, non-randomized, open-label study involving 39 patients diagnosed with RRMS was conducted to assess fatigue and/or cognition at 4 predetermined study visits (month 0, 3, 9, 15). A baseline clinical history was conducted at visit 1. Patients were allocated to treatment with IFN beta -1a intramuscular (IM), IFN beta -1a subcutaneous (SC) or IFN beta -1b at visit 2 according to physician recommendation. Fatigue was measured using the Modified Fatigue Impact Scale (MFIS), while cognition was measured using the Brief Repeatable Battery of Neuropsychological Tests (BRB) at each study visit. Results: The results of a multivariate analysis for 39 patients (IFN beta -1a (SC), 18; IFN beta -1a (IM), 9; IFN beta -1b, 12) are reported. Significant improvements were observed in cognition from visits 2 through 4, in 3 of 5 BRB cognitive domains, in each treatment group. Patient fatigue remained stable for patients on IFN beta -1a (SC) (average adjusted MFIS score (standard error) = 57.8 (4.2), 54.8 (4.1) and 52.2 (4.4) at visits 2, 3 and 4, respectively) and IFN beta -1a (IM) (average adjusted MFIS score = 60.4 (5.9), 54.1(5.9) and 58.3 (6.0) at visits 2, 3 and 4, respectively), but worsened significantly between visits 3 and 4 with IFN beta -1b treatment (average adjusted MFIS score = 57.6 (4.7), 51.9 (4.7) and 61.6 (4.9) at visits 2, 3 and 4, respectively) (p<.05). Conclusions: This research has identified a potential role of IFN- beta therapy to attenuate MS-induced cognitive deficits with preferential merit for using IFN beta -1a over IFN beta -1b in patients that suffer MS-induced fatigue at the onset of their disease.