Enhanced benefit of increasing interferon beta-1a dose and frequency in relapsing multiple sclerosis: The EVIDENCE study

Steven R. Schwid, John Thorpe, Mohammad Sharief, Magnhild Sandberg-Wollheim, Kottil Rammohan, Jeanette Wendt, Hillel Panitch, Douglas Goodin, David Li, Peter Chang, Gordon Francis

Research output: Contribution to journalArticlepeer-review

73 Scopus citations


Background: The EVIDENCE (Evidence of Interferon Dose-Response: European North American Comparative Efficacy) Study demonstrated that patients with multiple sclerosis (MS) who initiate interferon beta-1a therapy with 44 μg 3 times weekly (TIW) were less likely to have a relapse or activity on magnetic resonance imaging (MRI) compared with those who initiate therapy at a dosage of 30 μg 1 time weekly (QW). Objective: To determine the effect of changing the dosage from 30 μg QW to 44 μg TIW in this extension of the EVIDENCE Study. Design/Patients: Patients with relapsing MS originally randomized to interferon beta-1a, 30 μg QW, during the comparative phase of the study changed to 44 μg TIW, whereas patients originally randomized to 44 μg TIW continued that regimen. Patients were followed up, on average, for an additional 32 weeks. Main Outcome Measure: The within-patient pretransition to posttransition change in relapse rate. Results: At the transition visit, 223 (73%) of 306 patients receiving 30 μg QW converted to 44 μg TIW, and 272 (91%) of 299 receiving 44-μg TIW continued the same therapy. The posttransition annualized relapse rate decreased from 0.64 to 0.32 for patients increasing the dose (P<.001) and from 0.46 to 0.34 for patients continuing 44-μg TIW (P = .03). The change was greater in those increasing dose and frequency (P = .047). Patients converting to the 44-μg TIW regimen had fewer active lesions on T2-weighted MRI compared with before the transition (P = .02), whereas those continuing the 44-μg TIW regimen had no significant change in T2 active lesions. Patients who converted to high-dose/high-frequency interferon beta-1a therapy had increased rates of adverse events and treatment terminations consistent with the initiation of high-dose subcutaneous interferon therapy. Conclusions: Patients receiving interferon beta-1a improved on clinical and MRI disease measures when they changed from 30 μg QW to 44 μg TIW.

Original languageEnglish (US)
Pages (from-to)785-792
Number of pages8
JournalArchives of neurology
Issue number5
StatePublished - May 2005
Externally publishedYes

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology


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