Interferon beta and glatiramer acetate therapy

Abstract

Interferon beta and glatiramer acetate have been mainstays of treatment in relapsingremitting multiple sclerosis for two decades. Remarkable advances in our understanding of immune function and dysfunction as well as increasingly sophisticated clinical trial design have stemmed from efforts to better understand these drugs. In this chapter, we review the history of their development and elaborate on known and theorized mechanisms of action. We describe the pivotal clinical trials that have led to their widespread use. We evaluate the clinical use of the drugs including tolerability, side effects, and efficacy measures. Finally, we look to the future of interferon beta and glatiramer acetate in the context of an ever growing armamentarium of treatments for relapsing remitting multiple sclerosis.

Fig. 1

Timeline of IFN and GA trials. All dosing frequencies are as per current FDA approvals except where indicated. Representations of lengths of studies are approximate. Dates were derived from trial publications and listings on ClinicalTrials.gov. Pl = placebo, SC = subcutaneous, IM = Intramuscular, qwk = once weekly, BID = twice daily, FDA ✓ = US food and drug administration initial approval