Friday, October 12, 2007

Betaferon® treatment delays disability in early MS; strong efficacy not affected by neutralizing antibodies





Prague, October 12, 2007 – Betaferon® (interferon beta-1b) significantly delays the development of confirmed disability progression and the development of clinically definite multiple sclerosis (MS) in patients who are treated shortly after their first clinical MS event or “attack”. The presence of neutralizing antibodies (NAbs) does not affect the efficacy of early Betaferon® treatment.(1) This is according to new evidence from the landmark BENEFIT (BEtaferon in Newly Emerging multiple sclerosis For Initial Treatment) study presented today at the 23rd Congress of the European Committee for Treatment and Research in MS (ECTRIMS).

Neutralizing antibodies can develop in MS patients being treated with any of the currently available immunomodulatory therapies. However, there has been debate over whether or not such antibodies can affect a treatment’s efficacy.

“BENEFIT is a significant trial that provided the medical community with the first clear evidence on the value of treating patients with Betaferon® at the first clinical sign of MS to delay the accumulation of disability,” said Dr. Mark S. Freedman, Professor of Neurology at the University of Ottawa and investigator of the study. “The new data show that the presence of NAbs, regardless of the titre, does not reduce the efficacy of Betaferon® out to 3 years when administered after the first attack of MS. These results do not support the suggestion that the propensity for developing NAbs be a determining factor when making treatment decisions regarding Betaferon®.”

The study presented at ECTRIMS shows that:

• In patients starting treatment after a first MS attack, the efficacy of Betaferon® treatment in delaying the development of CDMS (Clinically Definite MS) and delaying confirmed disability was not affected by NAbs, regardless of NAb titre. Disability was measured using a validated, well-established scale called EDSS (Expanded Disability Status Scale) (2)

• Of 277 patients treated early with Betaferon®, 31.8 percent (88) were tested positive at least once for NAbs (≥1:20 NU/ml). 16.6 percent (46) of 277 patients had NAb titres ≥1:100 NU/ml, and 9 percent (25) had titres ≥1:400 NU/ml.

• 46.6 percent (41 of 88) of all patients with a documented NAb status reverted to NAb-negative status by Year 3. Among patients with higher NAb titres, 37 percent and 32 percent with NAb titres ≥1:100 NU/ml and ≥1:400 NU/ml, respectively, reverted to NAb-negative status by Year 3.

"The data from the BENEFIT study continue to provide the medical community with important insights that will help to optimize the treatment of patients in the earliest stages of MS. These results support previously published, peer-reviewed research showing that the NAb status does not affect the efficacy of Betaferon®," said Darlene Jody, M.D., Senior Vice President and President of Bayer HealthCare’s Specialized Therapeutics Global Business Unit.

Previously presented and published results of BENEFIT(3) demonstrated that over 3 years, patients treated with Betaferon® after the first MS attack had a 40 percent lower risk of developing confirmed disability and a 41 percent lower risk of developing clinically definite MS when compared to patients in whom treatment was delayed. No other MS therapy has demonstrated this effect in this early patient population.

Around the world, Betaferon® is approved for the treatment of relapsing forms of multiple sclerosis to reduce the frequency of clinical exacerbations, as well as for use in patients after the first attack of MS.

About BENEFIT
BENEFIT is a multi-center trial conducted at 98 sites in 20 countries and included patients presenting with a first clinical episode suggestive of MS and typical MRI findings. The primary outcome measures are time to diagnosis of CDMS (Clinically Definite MS), time to confirmed EDSS (Expanded Disability Status Scale) progression and patient reported Quality of Life outcomes (FAMS-TOI). A total of 468 patients were randomized to receive either 250 micrograms of interferon beta-1b (Betaferon®) every other day or placebo as a subcutaneous injection in a double-blind fashion. The placebo-controlled treatment period lasted up to 24 months or up to the time when patients experienced a second attack and were diagnosed with clinically definite MS. All study participants were then invited to participate in a follow-up study with Betaferon® to prospectively assess the impact of such early versus delayed treatment with Betaferon® on the long-term course of the disease for a total observation time of five years. The three-year results are from a pre-planned analysis.

Previous published studies in this patient population have been criticized as less scientifically rigorous, because of their retrospective nature, unblinded assessments and the high number of patients lost to follow-up. The BENEFIT study was the first study in early MS patients designed to overcome these shortcomings.

About Betaferon® / Betaseron®
Betaferon®, which is marketed in the U.S. and Canada under the trademark Betaseron®, was the first disease-modifying drug introduced for MS and is a well-established treatment around the world. In the U.S., Europe and Japan, Betaferon® has been approved for all relapsing forms of MS. It is able to reduce the number of MS episodes by one-third, and the frequency of moderate to severe episodes by as much as 50 percent. Sixteen years’ follow-up of people treated with Betaferon® has shown that it is safe and well tolerated.

About Multiple Sclerosis
MS is a chronic, progressive disease of the central nervous system and the likelihood of disability increases the longer someone has MS. Symptoms of MS vary from person to person and can be unpredictable. They may include: Fatigue or tiredness, dimness of vision in one or both eyes, weakness of one or both legs, numbness and tingling in the face, arms, legs and trunk of the body, spasticity (muscle stiffness), dizziness, double vision, slurred speech and loss of bladder control.

References
(1) Freedman MS, Edan G, Hartung H-P, et al. Neutralising antibodies did not affect clinical outcomes after 3 years in the BENEFIT (BEtaferon in Newly Emerging multiple sclerosis For Initial Treatment) study. 23rd Congress of the European Committee for Treatment and Research in Multiple Sclerosis, 2007
(2) Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983; 33: 1444–52
(3) Kappos L et al. Effect of early versus delayed interferon beta-1b treatment on disability after a first clinical event suggestive of multiple sclerosis: a 3-year follow-up analysis of the BENEFIT study. Lancet 2007 Aug 4; 370(9585): 389-97

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