Natalizumab v. interferons with cost measure

NEW YORK (Reuters Health) May 11 - Natalizumab is comparable to interferon beta-1a in the net health benefits it provides for relapsing multiple sclerosis, an analysis of published data suggests. Previous reports have shown natalizumab to be effective in preventing relapsing and slowing disease progression, but the drug has also been linked to an increased risk of progressive multifocal leukoencephalopathy (PML), which often proves fatal. Whether the benefits of natalizumab provides offsets this risk is unclear. In the current study, Dr. Ray Dorsey, from the University of Rochester Medical Center in New York, and colleagues analyzed published data to assess the quality-adjusted life years (QALYs) gained with natalizumab. A comparison was then made with interferon beta-1a. Data for the natalizumab analysis was drawn from the Natalizumab Safety and Efficacy in Relapsing Multiple Sclerosis (AFFIRM) trial, while the interferon data came from the Prevention of Relapses and Disability by Interferon Beta-1a Subcutaneously in Multiple Sclerosis (PRISMS) study. Each study lasted roughly 2 years. The investigators report their findings in the May 1st issue of Neurology. The authors found that in terms of the effect on QALYs, natalizumab was minimally more effective than interferon at reducing disease relapses. The agents were comparable in their ability to slow disease progression. Because natalizumab did carry a slight risk of PML, the final net health effect of the drugs was nearly identical - 0.033 QALYs gained. 'Over the first 2 years of therapy, the health effect of natalizumab for the treatment of relapsing multiple sclerosis is much greater than the expected harm from PML,' the authors conclude. Still, they write, long-term observational studies are needed to fully characterize the risk of PML with this drug. Neurology 2007;68:1524-1528. Multiple Sclerosis (MS) Reuters Health Information 2007. 2007 Reuters Ltd.