Abstract
Background: Multiple sclerosis (MS) is one of the neuroinflammatory disorders that commonly affect the young. Injectable interferons beta-1a (Rebif 22-44, Betaseron 250 and Avonex 30) are one of the most important first line disease modifying therapies with less side effects compared to others. But the injection site reaction (ISR) is an important side effect, which can decrease the patient’s compliance to the medications that will lead to the disease progression.
Objective: The purpose of this study was to compare the ISR in the three types of interferon (2 subcutaneous  Rebif 22-44, Betaseron 250 and one intramuscular Avonex 30) and determine whether the route of administration (subcutaneous versus intramuscular) affects the frequency of ISR, and to reduce this side effect and ensure compliance. 
Methods: This was a single center, prospective observational study of 300 patients at King Fahad University Hospital (Al Khobar, Saudi Arabia) form September 2015 to August 2016 with a relapsing remitting form of multiple sclerosis for which 114 patents were receiving injectable interferon. A questionnaire was filled out by the participants including type of interferon, type of ISR and pain severity. Patients were then evaluated in our MS clinic and dermatology clinic after 1 week and 3 months. Data were analyzed by IBM-SPSS version 21. Appropriate statistical tests will be mandated per the collected data. Statistical significance is determined at p-value<0.05 with a confidence interval of 0.95. Frequency and proportion, and relative risks (RR) were calculated and Chi-square test was used.
Results: ISRs in the form of erythema were reported by fewer patients on Avonex group 21.1% compared to the other two injectables, Betaseron group (77.8%, p<0.0001, RR=2.6) and Rebif groups (69.8%, p<0.0001, RR=2.3). Similar observations were noticed 3 months later, where the Avonex group had statistically significant less ISRs with no abnormality in 89.9% compared to (52.3%, p<0.0001, RR=3.5) and (44.4%, p<0.0001, RR=4.2) in Rebif and Betaseron respectively. Only patients on Rebif had skin ulceration 3.5% (n=3) at initial assessment; however, there was insignificant difference and none of the patients had skin ulceration at the 3 months’ evaluation. 
Conclusions: Interferon beta-1a (Avonex) found to be the least to cause ISR compared to Rebif and Betaseron.
 
Keywords: Multiple sclerosis, Injection site reaction (ISR), Interferon beta

 

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Current Issue

July-September 2019 (Volume 11, Issue 3)


 

Previous Issue

In the second issue of the journal Electronic Physician for 2019, we have several papers including four Randomized Controlled Trials, a model development study, a case report, an editorial, a letter to editor (LTE), and several original research including two studies with qualitative approach. Authors of this issue are from nine countries: Iran, The Netherlands, Sweden, Italy, India, Thailand, Saudi Arabia, United Arab Emirates (UAE), and Jordan. Read more...


 

The 6th World Conference on Research Integrity (WCRI) is to be held on June 2-5, 2019 in Hong Kong.

The WCRI is the largest and most significant international conference on research integrity. Since the first conference in Lisbon in 2007, it has given researchers, teachers, funding agencies, government officials, journal editors, senior administrators, and research students opportunities to share experiences and to discuss and promote integrity in research. Read more:


 

TDR Clinical Research and Development Fellowships

Call for applications

Deadline for submission: 7 March 2019, 16:00 (GMT)

TDR provides fellowships for early- to mid-career researchers and clinical trial staff (e.g. clinicians, pharmacists, medical statisticians, data managers, other health researchers) in low- and middle-income countries (LMICs) to learn how to conduct clinical trials. Read more:


Meta-Analysis Workshops in New York, USA, and London, UK, in April and May 2019

Don't miss this exceptional opportunity to learn how to perform and report a Meta-analysis correctly. Two Meta-analysis workshops are organized in April and May 2019 by Dr. Michael Borenstein in New York, USA (April 08-10, 2019) and London, UK (May 27-29).

About the Instructor

Dr. Michael Borenstein, one of the authors of Introduction to Meta-Analysis, is widely recognized for his ability to make statistical concepts accessible to researchers as well as to statisticians. He has lectured widely on meta-analysis, including at the NIH, CDC, and FDA. Read more: