Sven Meuth, MD, PhD, reviews the mechanism of action of interferon and its long-standing use in relapsing multiple sclerosis.
You let’s take a look at the the individual region that will start with interferon since that was our our first agent so spend it tell us a little bit about use of interferon both historically and we’re a plays a role now yeah i mean it was heavily used twenty years ago when it was coming to the market and the majority of patients in germany were treated with the
Different interferon beta preparations over years however since the approval of the oral agents emf and tariff alone imide we don’t find too many patients starting with interference anymore so it’s there is a significantly a decrease in the usage of interference however especially patients being stable over years on interference they like to continue therapy with
These injectables and so never change winning team interferon patients who are stable on treatment continue this treatment however for newly diagnosed patients they are looking at least in our country more for the oral agents and so there is a development in this injectable market i have to say yeah this is a quite good question and i think we can spend the next
30 minutes talking about the mechanism of action so for our patients we we tried to keep it simple and we are talking about a shift from th1 responses towards th2 responses but i think we we all know that there are many effects contributing to the mechanism of action of interference i think if we have the pathophysiology of a mess in mind we can nearly say that
Each and every step in this whole cascade is somehow impacted by interference so it alters the the cellular recognition by a modulation of mhc 2 and the t cell receptor it reduces thereby lymphocyte activation and proliferation but it has also an impact on the transmigration of the blood-brain barrier from the periphery to the central nervous system and and some
People or there is some data published that also in the cns this leads to a down regulation of pro-inflammatory cytokines and it shifts somehow the differentiation also in the cns towards th to answer so i already brought mechanism of action not entirely clear which one is being the primary player if there is a primary mechanism involved wow interferon uk yeah so
I think that i’m sure like in other countries that our use of interferon as a first line or a first dmt for people with ms is definitely on the downward slope i guess a couple of new things a couple of one new thing in the last year would be the change in the label for pregnancy in in europe so we now have the option of treating women wanting to fall pregnant or
During pregnancy and breastfeeding and that’s on the basis of observational studies suggesting this approach is safe and i think there’s also still a role for interferons and other injectable therapies in patients with certain comorbidities that make other treatments difficult so i recently saw a patient who had a renal transplant and so their immunosuppressed on
Two immunosuppressive medications and low dose steroids and they developed relapsing or missing multiple sclerosis on top of on top of that so one of the injectable agents the patient in this case we’ve interferon is a good option because you don’t need to worry about drug interactions or immunosuppressive effects with regard to interferon beta i think the use
Is is absolutely dropping in the united states but i agree with then patients that are on it that are doing very well that are very happy with it not having any significant side effects there would certainly be no reason to change them we’ve had the same experience haven’t started many patient if your honor but i have all home contrib individuals of i be treating
Since november of 1993 when we first got interferon beta one day and they’ve done just spectacularly well i mean as we know with all of these ages there are some people who have responded to all of them and and i think they don’t change the winning team was much the logic they may say well i’m not that happy about these injections but i don’t want to change because
I’ve done so well over the years i must say going back to 1993 because there was one of the most exciting periods of my professional life and we had our first therapy come along for a disease so it’s really a very exciting time the other issue with interferon right here and now is it’s when i gotten phone calls from patients as we all have saying what about this
Copán 19 the ones that are calling on interferon i say you’re in a great position because not only doesn’t an immunosuppressive but interference by the innate immune response that helps you to fight off viral infections so we’re happy to have you one on interferon and so i think they’ll continue to be a use for even individuals and and we’ll come back to to the
Comorbidity issue after we have a discussion about litter more acid thing
Transcribed from video
The Use of Interferon in Multiple Sclerosis By Neurology Live
