The use of interferon beta at the time of initial diagnosis of multiple sclerosis

Abstract

Dr Hodgkinson points out the increasing evidence that damage to axons as well as to myelin can occur early in the clinical course of multiple sclerosis (MS) and accumulates over time. This indicates the need for a safe effective treatment for MS from its onset. The main question here is whether interferon beta meets this need. Dr Macdonell makes it clear that when considering this therapy one has to take into account the nature of the disease at the time of clinical presentation. Currently it is unclear whether interferon beta is beneficial in secondary progressive MS, and so its initiation at this stage of MS is probably best avoided. Certainly interferon beta should be avoided in primary progressive MS at present, as there is no evidence that it has a beneficial clinical effect and indeed there is one report that it actually worsens the clinical picture by increasing spasticity.