MULTIPLE SCLEROSIS AND BETA INTERFERON

Many reports have recently appeared in the media about the drug Beta Interferon and its use in treating multiple sclerosis. This publicity has not always provided a full and clear picture, and many people have found the information conflicting and confusing. This text gives some information about Beta Interferon and its use, and explains how the drug is made available on the NHS.

The information is based on guidance developed by hospital neurologists, general practitioners, health authorities, and by representatives of the MS Society. It follows national advice from researchers, consultants, and the Department of Health. All GPs and consultants follow the same guidelines, so all patients can be reassured that they will be considered equally.

Introduction

After a clinical trial, Beta Interferon was licensed in the UK in December 1995. The drug is not a cure for MS, but there was some evidence of a benefit in terms of a reduced relapse rate for patients with relapsing-remitting MS. The trial suggested that the relapse rate was reduced by about one third. Many neurologists have expressed doubts about the scientific quality of the evidence. "Relapsing-remitting" means that the symptoms come and go, i.e. attacks are followed by recovery.

Beta Interferon is not considered suitable for MS patients whose illness started with relapses and remissions, but who then developed a progressive disability, or for those with the progressive form of the disease, or for those who are already disabled. Therefore it is unlikely to help many MS patients who are disabled by established disease. The trial did not show any effect at all on disability.

Side-effects

Treatment with Beta Interferon means injecting yourself every other day and short-term side effects may include inflammation at the injection side. Flu-like symptoms for the first few months of treatment are also common. There are some other side-effects, including episodes of severe depression. Having been used in the treatment of MS for only a few years, there is insufficient evidence to assess the effect of long-term use. Patients who are, or may be likely to become, pregnant should not receive Beta Interferon.

Prescribing Beta Interferon

Potentially suitable patients are identified carefully. If you have the relapsing-remitting form of MS, and you think that you might be suitable for treatment, first make an appointment to see your GP. However, your GP will not prescribe Beta Interferon, only hospital neurologists do this (this in line with national advice). But, if it seems that Beta Interferon might help you, your GP will make an appointment for you to see your local hospital neurologist at an outpatient clinic. The neurologist will then make the final decision. Once prescribed the drug, the neurologist and your GP will keep a close eye on your progress, especially in the first few weeks. For some patients, side-effects are so severe that Beta Interferon has to be stopped.

Referral

There are many conditions to satisfy before being referred by your GP to the local hospital neurologist. The main one is that you have relapsing-remitting MS, as diagnosed by a consultant neurologist, and have had two disabling relapses in the last to years, with at least one of those in the last year. These relapses should have significantly affected your work or your ability to do things around the house, or meant that you needed to go into hospital or have a course of steroids.

In addition, you must be able to walk for 100 yards without assistance or stopping; and be prepared to inject yourself with Beta Interferon every other day (or have someone who would do it for you). You must know about, and be prepared to put up with, the likelihood of getting flu-like symptoms in the first few months of treatment.

Your GP will not be prepared to refer you if you have had only one severe relapse, with no recurrences, or have had no relapses for two years, or have chronic progressive MS. Nor will you be referred if you need a stick, walking frame, or wheelchair. Another reason for non-referral is pregnancy or breast-feeding, or a likelihood of becoming pregnant. Lastly, you must be over 18 years old.

There is no evidence that Beta Interferon can benefit those aged over 50 or those who have suffered from depression, have severe liver disease or epilepsy, or are taking immuno-suppressive drugs, other than steroids.

More written information is given in the MS Society leaflet "What the Charities Say - a guide for people with MS, their families and carers".

Further information

MS Society of GB and N Ireland
25 Effie Road
London
SW6 1EE
020-7736 6267
Helpline: 020-7371 8000
Health information service (free calls): 0800 665544