multiple sclerosis compare interferons

Etemadifar M et al. Comparison of Betaferon, Avonex and Rebif in treatment of relapsing-remitting multiple sclerosis Acta Neurol Scand 2006 1113:283-287

Head to head trial single blind randomized trial of rrms patients with active disease (>2 relapses in 2 years) and EDSS < 5. 90 patients. Design was to see which agent is best to prevent progression of MS.

High dose agents were better than avonex on number of patients who were relapse free for two years (B 43 %, R 56% A 20%). EDSS declined more with high dose than with Avonex. However, looking at table 3, all three groups had mean EDSS under 2.

Conclusion in the paper that high dose is better is contradicted by the clinical effect size, as all three drugs had low EDSS at conclusion of the trial.