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Interferon-β1b in der Multiple-Sklerose-Therapie

Mehr als 20 Jahre klinische Erfahrung

Interferon-β1b in multiple sclerosis therapy

More than 20 years clinical experience

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Zusammenfassung

Die Einführung von Interferon-β1b im Jahre 1993 in den USA und 2 Jahre später auch in Europa war ein Meilenstein in der Immuntherapie der Multiplen Sklerose (MS). Bis dahin galt die Erkrankung bei der Mehrheit der Neurologen als unbehandelbar. Die Studienergebnisse mit Interferon-β1b zeigten erstmals überzeugend, dass der Verlauf der schubförmigen Multiplen Sklerose günstig beeinflussbar ist. Es folgte die Zulassung von Interferon-β1b zur Behandlung von Patienten mit sekundär progredienter MS mit Krankheitsaktivität (1999) sowie der möglichen frühen schubförmigen MS nach einem ersten demyelinisierenden Ereignis (klinisch isoliertes Syndrom, CIS; 2006). Die vorliegende Publikation gibt einen Überblick über die Erfahrung mit der mehr als 20-jährigen klinischen Anwendung von Interferon-β unter besonderer Berücksichtigung der Langzeitergebnisse im Hinblick auf Wirksamkeit und Sicherheit sowie der Bedeutung eines frühzeitigen Therapiebeginns. Daneben werden die folgenden Aspekte diskutiert: vermuteter Wirkmechanismus von Interferon-β, Indikationen für eine krankheitsmodifizierende Therapie, klinische Relevanz neutralisierender Antikörper, Bedeutung der Compliance in der MS-Therapie, hoch- vs. niedrigfrequente Behandlungsstrategie, Kombinationstherapien mit Interferon-β, Sicherheit von Interferon-β bei Kindern und Jugendlichen mit MS sowie in der Schwangerschaft.

Summary

The introduction of interferon-β1b in 1993 in the USA and 2 years later in Europe made it possible for the first time to alter the course of the disease in patients with relapsing-remitting multiple sclerosis (MS). Subsequently, interferon-β1b was approved for the treatment of patients with active secondary progressive MS (1999) and early relapsing-remitting MS following a first demyelinating event (clinically isolated syndrome, CIS) (2006). Here we provide an overview of the clinical experience gathered during more than 20 years of interferon-β use focusing on long-term efficacy and safety and the impact of early initiation of treatment. Furthermore, the following aspects will be discussed: putative mechanisms of action of interferon-β, indications for a disease-modifying therapy, clinical relevance of neutralizing antibodies, importance of adherence in MS therapy, high versus low frequency therapy, combination therapies with interferon-β and safety of interferon-β in children and adolescents with MS and during pregnancy.

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Interessenskonflikt

Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehungen hin: Prof. Dr. Hartung, mit Genehmigung des Rektors der HHU und des Ärztlichen Direktors des UKD, und Prof. Dr. Haas haben Honorare für Vorträge bei Symposien und für Beratung von der Firma Novartis Pharma GmbH erhalten und als Studienärzte an von Novartis unterstützten Studien teilgenommen. Dres. Meergans, Ortler und Tracik sind Angestellte der Firma Novartis Pharma GmbH.

Ein früherer Entwurf des Manuskripts wurde mit Unterstützung der Medical Writer Dr. Matthias Herrmann und Dr. Christoph May verfasst. Dr. May ist Angestellter der Firma Novartis Pharma GmbH.

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Authors and Affiliations

  1. Neurologische Klinik im UKD, Medizinische Fakultät, Heinrich-Heine Universität, Moorenstr. 5, 40225, Düsseldorf, Deutschland

    H.-P. Hartung & F. Tracik

  2. Jüdisches Krankenhaus Berlin, Berlin, Deutschland

    J. Haas

  3. Novartis Pharma GmbH Nürnberg, Nürnberg, Deutschland

    M. Meergans, F. Tracik & S. Ortler

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  1. H.-P. Hartung
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  2. J. Haas
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  3. M. Meergans
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  4. F. Tracik
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  5. S. Ortler
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Correspondence to H.-P. Hartung.

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Hartung, HP., Haas, J., Meergans, M. et al. Interferon-β1b in der Multiple-Sklerose-Therapie. Nervenarzt 84, 679–704 (2013). https://doi.org/10.1007/s00115-013-3781-0

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