PMID- 19064873
OWN - NLM
STAT- MEDLINE
DCOM- 20090105
LR  - 20151119
IS  - 1526-632X (Electronic)
IS  - 0028-3878 (Linking)
VI  - 71
IP  - 24 Suppl 3
DP  - 2008 Dec 9
TI  - Disease-modifying therapy in multiple sclerosis: update and clinical 
      implications.
PG  - S8-13
LID - 10.1212/WNL.0b013e31818f3d8b [doi]
AB  - As new therapies become available for the treatment of multiple sclerosis, the 
      relative value of established and newer disease-modifying therapies must be 
      considered. However, comparing the apparent efficacy of different agents across 
      clinical trials is not easy and can be misleading when different therapies have 
      been studied during different time periods. There has been a shift in current 
      clinical trials toward enrolling patients with less advanced or less active 
      disease compared with trials undertaken when no effective therapies were 
      available. If early treatment is more effective than late treatment, this 
      practice will produce a bias in favor of newer agents. Head-to-head trials offer 
      the most reliable means of comparing therapies, but these trials are expensive 
      and time consuming. Consequently, cross-trial comparisons are necessary, but a 
      reliable means to make such comparisons is needed. One useful (but imperfect) 
      approach is to compute the relative risk of therapy and the 
      number-needed-to-treat, applying both measures to any cross-trial comparison. 
      These measures capture different aspects of the trials (relative and absolute 
      differences) and, if they agree, this suggests that the cross-trial comparison 
      may be valid. If the two methods disagree, no reliable conclusion about relative 
      efficacy can be made. There are only two valid conclusions from the available 
      head-to-head and cross-trial data. First, high-dose interferon-beta (IFN beta)-1a 
      or IFN beta-1b subcutaneous has a greater impact than weekly IFN beta-1a IM on 
      several clinical and MRI outcomes. Second, high-dose IFN beta-1a or IFN beta-1b 
      subcutaneous has a similar clinical impact to glatiramer acetate, although IFN 
      beta subcutaneous is superior on some MRI outcome measures.
FAU - Goodin, Douglas S
AU  - Goodin DS
AD  - Department of Neurology, University of California, San Francisco, CA, USA. 
      douglas.goodin@ucsf.edu
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neurology
JT  - Neurology
JID - 0401060
RN  - 145155-23-3 (Interferon beta-1b)
RN  - 77238-31-4 (Interferon-beta)
RN  - XRO4566Q4R (Interferon beta-1a)
SB  - IM
MH  - *Clinical Trials as Topic
MH  - Disease Progression
MH  - Humans
MH  - Interferon beta-1a
MH  - Interferon beta-1b
MH  - Interferon-beta/therapeutic use
MH  - Multiple Sclerosis/*drug therapy/pathology/physiopathology
MH  - Risk Factors
MH  - Treatment Outcome
EDAT- 2008/12/17 09:00
MHDA- 2009/01/06 09:00
CRDT- 2008/12/17 09:00
PHST- 2008/12/17 09:00 [pubmed]
PHST- 2009/01/06 09:00 [medline]
PHST- 2008/12/17 09:00 [entrez]
AID - 71/24_suppl_3/S8 [pii]
AID - 10.1212/WNL.0b013e31818f3d8b [doi]
PST - ppublish
SO  - Neurology. 2008 Dec 9;71(24 Suppl 3):S8-13. doi: 10.1212/WNL.0b013e31818f3d8b.