A Systematic Review on the Efficacy of Interferon Beta in Relapsing Remitting Multiple Sclerosis; Comparison of Different Formulations

Interferon beta (IFN beta) an immunomodulatory agent has been approved for Multiple Sclerosis (MS) patients with a relapsing course. The aim of this meta-analysis was to compare three different formulations of IFN beta including intramuscular IFN beta-1a (Avonex(R)), subcutaneous IFN beta-1a (Rebif(R)) and subcutaneous IFN beta-1b (Betaseron or Betaferon) in Relapsing Remitting MS (RRMS). Pubmed, Scopus and Cochrane Central Register of controlled trials were searched for studies comparing efficacy of different formulations of IFN beta in RRMS. Data were collected from 1966 to 2009 (up to July). Mean change in Expanded Disability Status Scale (EDSS) and number of patients with at least one relapse were the key outcomes of interest for assessment of efficacy. Six studies met our criteria and were included. Comparison of Avonex with Rebif yielded a non-significant Relative Risk (RR) of 0.85 (95% CI of 0.57-1.25, p = 0.3954). A non-significant RR of 0.91 (95% CI of 0.75-1.10, p = 0.3378) was obtained when Avonex compared with Betaferon. Comparison of Rebif with Betaferon yielded a significant RR of 0.9 (95% CI of 0.82-1, p = 0.0481). Although, not statistically significant, Rebif or Betaferon work better than Avonex whereas Betaferon was even better than Rebif in management of RRMS.