Interferon, azathioprine and corticosteroids in multiple sclerosis: 6-year follow-up of the ASA cohort

Clin Neurol Neurosurg. 2012 Sep;114(7):940-6. doi: 10.1016/j.clineuro.2012.02.014. Epub 2012 Mar 7.

Abstract

Objective: To evaluate long-term effects of 2-year treatment with interferon beta combined with low-dose azathioprine and prednisone in multiple sclerosis.

Methods: In the original 2-year ASA study, 181 patients with early relapsing-remitting multiple sclerosis were randomised into 3 treatment arms: those treated with interferon beta (n=60), with interferon beta and low-dose azathioprine (n=58), and interferon beta, azathioprine and low-dose prednisone (n=63). Of these, 172 were included in this 4-year non-study extension. Three monthly clinical controls and annual MRI scans were carried out. The primary endpoint was annual relapse activity. The secondary endpoints were disability and quantitative MRI parameters.

Results: Nine patients were lost to follow-up and 172 were included in the analyses. None of relapse activity, disability accumulation or MRI parameters differed significantly between the groups over 6 years. Only 5.5% and 0.6% of patients were free from disease activity at year 2 and year 6 of the treatment initiation.

Conclusion: The tested combined therapeutic regimen does not improve long-term outcomes in patients with multiple sclerosis. Furthermore, interferon is not able to completely abolish disease activity.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adjuvants, Immunologic / administration & dosage
  • Adjuvants, Immunologic / therapeutic use*
  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Azathioprine / therapeutic use*
  • Brain / pathology
  • Cohort Studies
  • Disability Evaluation
  • Disease Progression
  • Double-Blind Method
  • Drug Therapy, Combination
  • Endpoint Determination
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Injections, Intramuscular
  • Interferon beta-1a
  • Interferon-beta / administration & dosage
  • Interferon-beta / therapeutic use*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / pathology
  • Prednisone / therapeutic use
  • Recurrence
  • Treatment Failure
  • Young Adult

Substances

  • Adjuvants, Immunologic
  • Adrenal Cortex Hormones
  • Immunosuppressive Agents
  • Interferon-beta
  • Azathioprine
  • Prednisone
  • Interferon beta-1a