- Author(s): P. Perini, A. Facchinetti, P. Bulian, A.R. Massaro, D. De Pascalis, A. Bertolotto, G. Biasi, P. Gallo
, Department of Neurological & Psychiatrical Sciences, Second Neurological Clinic, Geriatric Hospital, Via E. Vendramini 7, 35137 Padova, Italy.
- Key words: interferon-beta, natural autoantibodies, multiple sclerosis.
- Page(s) : 56-61
- Published in: 2001
We analysed the role of dosage, route and frequency of administration of clinical grade interferon-beta (IFN-b) preparations in inducing anti-IFN-b antibodies (IFN-b-Abs) in 5 groups of relapsing-remitting multiple sclerosis (RRMS) patients who were respectively treated as follows: 1) weekly intramuscular (i.m.) injections of 30 mg of recombinant IFN-b1a (Avonex™), 2) subcutis (s.c.) injections of 250 mg IFN-b1b (Betaferon®) every other day, 3) weekly i.m. injections of 250 mg IFN-b1b (Betaferon®), 4) s.c. injections of 22 mg of IFN-b1a (Rebif®) three times a week, and 5) i.m. injections of 22 mg of IFN-b1a (Rebif®) twice a week. IFN-b-Abs were determined by ELISA. IFN-b1b was more immunogenic than IFN-b1a not only when administered s.c. every other day, but also when administered i.m. at a lower weekly dose; i.m. injection, however, significantly delayed the appearance, and induced lower serum levels of IFN-b-Abs. In patients treated with s.c.
IFN-b1b, Ab levels peaked 3 to 9 months after therapy initiation, and then slowly, but progressively, declined to pre-therapy levels that in some patients were reached after three years. Patients treated with i.m. or s.c. IFN-b1a only rarely developed IFN-b-Abs, and then at very low titers. Overall, the i.m. weekly administration of IFN-b1a was the less immunogenic treatment. In IFN-b1b-treated patients, a wash-out period of two/three months was sufficient to bring the IFN-b-Ab levels below the cut-off. Our findings suggest that the immunogenicity of IFN-b1a is low, regardless of the route of administration and the dosage, while that of
IFN-b1b is high, and is significantly, but not completely reduced by i.m. administration. As IFN-b-Abs are cross-reactive, a wash-out period is suggested when the preparation is changed from IFN-b1b to IFN-b1a in order to maintain the clinical benefits of the therapy.