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对干扰素β产品治疗多发性硬化症的EVIDENCE、INCOMIN和III期研究结果的审查。

An examination of the results of the EVIDENCE, INCOMIN, and phase III studies of interferon beta products in the treatment of multiple sclerosis.

作者信息

Vartanian Timothy

机构信息

Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02115, USA.

出版信息

Clin Ther. 2003 Jan;25(1):105-18. doi: 10.1016/s0149-2918(03)90013-0.

Abstract

BACKGROUND

Three interferon (IFN) beta products are currently available for the treatment of relapsing multiple sclerosis (MS). Each of these agents showed effectiveness in the treatment of MS in the respective randomized, double-blind, placebocontrolled Phase III trials. However, there have been no randomized, double-blind, placebo-controlled trials directly comparing the efficacy and safety of these formulations.

OBJECTIVE

The objective of this article was to compare the results of available comparative studies with the results of the pivotal Phase III trials of each IFN beta product.

METHODS

BIOSIS, Current Contents/Clinical Medicine, and MEDLINE were searched for English-language articles published from 1996 to the present comparing the efficacy and safety of IFN beta formulations in the treatment of MS. Search terms included interferon beta 1a, interferon beta 1b, and multiple sclerosis. Articles or abstracts that reported the results of Phase III trials or studies directly comparing IFN beta formulations in the treatment of relapsing or relapsing-remitting MS were included in the review.

RESULTS

Seven head-to-head studies were identified that directly compared the efficacy of IFN beta products in the treatment of MS. Two of these studies- INCOMIN (Independent Comparison of Interferon) and EVIDENCE (Evidence for Interferon Dose-Effect: European-North American Comparative Efficacy)- found significant differences in clinical efficacy between IFN beta products, whereas the remaining studies showed equal clinical efficacy between products.

CONCLUSION

Inconsistencies within and between the results of the reviewed studies suggest that clinicians should use caution in interpreting the findings of the INCOMIN and EVIDENCE comparative trials.

摘要

背景

目前有三种干扰素β产品可用于治疗复发型多发性硬化症(MS)。在各自的随机、双盲、安慰剂对照III期试验中,这些药物均显示出对MS的治疗效果。然而,尚无直接比较这些制剂疗效和安全性的随机、双盲、安慰剂对照试验。

目的

本文旨在比较现有比较研究结果与各干扰素β产品关键III期试验结果。

方法

检索BIOSIS、《现刊目次/临床医学》和MEDLINE数据库,查找1996年至今发表的比较干扰素β制剂治疗MS疗效和安全性的英文文章。检索词包括干扰素β1a、干扰素β1b和多发性硬化症。纳入综述的文章或摘要需报告III期试验结果或直接比较干扰素β制剂治疗复发型或复发缓解型MS的研究结果。

结果

共确定了7项直接比较干扰素β产品治疗MS疗效的头对头研究。其中两项研究——INCOMIN(干扰素独立比较)和EVIDENCE(干扰素剂量效应证据:欧美比较疗效)——发现干扰素β产品之间临床疗效存在显著差异,而其余研究显示各产品临床疗效相当。

结论

综述研究结果内部及之间的不一致表明,临床医生在解读INCOMIN和EVIDENCE比较试验结果时应谨慎。

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