Multiple Sclerosis: Side Effects of Interferon Beta Therapy and Their Management

    November 1999 in “ Neurology ”
    E.U. Walther, Reinhard Hohlfeld
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    TLDR The article suggests managing interferon beta therapy side effects in MS with dose adjustments, medications, and patient education.
    The 1999 article reviewed the side effects of interferon beta (IFNß) therapy in treating multiple sclerosis (MS) and proposed management strategies. Common side effects, affecting up to 75% of patients, included flu-like symptoms, laboratory abnormalities, menstrual disorders, increased spasticity, and injection site reactions. Serious but less frequent side effects were autoimmune reactions, capillary leak syndrome, anaphylactic shock, thrombotic-thrombocytopenic purpura, insomnia, headache, alopecia, and depression. Management involved starting with a lower dose, using NSAIDs, oral prednisone, or pentoxifylline for flu-like symptoms, adjusting doses for laboratory abnormalities, oral contraceptives for menstrual issues, and antidepressants and psychotherapy for mood alterations. Patient education and monitoring were crucial for adherence and side effect management. Injection site reactions were more common with subcutaneous injections and in women, with severe cases requiring discontinuation of IFNß. Rare side effects included exacerbation of autoimmune diseases, worsening psoriasis, insomnia, hearing loss, and mild alopecia. Patients with autoimmune diseases or complement system disorders were advised to consider alternative treatments due to the risk of autoimmune reactions with IFNß therapy.
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