A 3.5-year study of over 3,000 MS patients, each taking one of the 4 injectable immunomodulatory drugs (Rebif, Copaxone, Betaseron, Avonex) has shown Copaxone and Rebif to have a "slightly lower relapse incidence" compared to Avonex and Betaseron. At least that's how I read the abstract below.
From Multiple Sclerosis Journal, December 5, 2014:
Comparative effectiveness of glatiramer acetate and interferon beta formulations in relapsing–remitting multiple sclerosis
Tomas Kalincik
Department of Medicine, University of Melbourne, Melbourne, Australia and Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
Vilija Jokubaitis
Department of Medicine, University of Melbourne, Melbourne, Australia and Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
Guillermo Izquierdo
Hospital Universitario Virgen Macarena, Sevilla, Spain
Pierre Duquette
Hôpital Notre Dame, Montreal, Canada
Marc Girard
Hôpital Notre Dame, Montreal, Canada
Pierre Grammond
Hotel-Dieu de Levis, Quebec, Canada
Alessandra Lugaresi
MS Center, Neuroscience, Imaging and Clinical Sciences, University ‘G. d’Annunzio’, Chieti, Italy
Celia Oreja-Guevara
University Hospital San Carlos, IdISSC, Madrid, Spain
Roberto Bergamaschi
National Neurological Institute C. Mondino, Pavia, Italy
Raymond Hupperts
Orbis Medical Center, Sittard, the Netherlands
Francois Grand’Maison
Neuro Rive-Sud, Hôpital Charles LeMoyne, Quebec, Canada
Eugenio Pucci
Ospedale di Macerata, Macerata, Italy
Vincent Van Pesch
Cliniques Universitaires Saint-Luc, Brussels, Belgium
Cavit Boz
Karadeniz Technical University, Trabzon, Turkey
Gerardo Iuliano
Ospedali Riuniti di Salerno, Salerno, Italy
Ricardo Fernandez-Bolanos
Hospital Universitario Virgen de Valme, Seville, Spain
Shlomo Flechter
Assaf Harofeh Medical Center, Beer-Yaakov, Israel
Daniele Spitaleri
AORN San Giuseppe Moscati, Avellino, Italy
Edgardo Cristiano
Hospital Italiano, Buenos Aires, Argentina
Freek Verheul
Groen Hart Ziekenhuis, Gouda, the Netherlands
Jeannette Lechner-Scott
John Hunter Hospital, Newcastle, Australia
Maria Pia Amato
Department NEUROFARBA, Section of Neurosciences, University of Florence, Florence, Italy
Jose Antonio Cabrera-Gomez
Centro Internacional de Restauracion Neurologica, Havana, Cuba
Maria Laura Saladino
INEBA, Buenos Aires, Argentina
Mark Slee
Flinders University and Medical Centre, Adelaide, Australia
Fraser Moore
Jewish General Hospital, Montreal, Canada
Orla Gray
Craigavon Area Hospital, Portadown, UK
Mark Paine
St Vincent’s Hospital, Melbourne, Australia
Michael Barnett
Brain and Mind Research Institute, Sydney, Australia
Eva Havrdova
Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine, General University Hospital and Charles University in Prague, Czech Republic
Dana Horakova
Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine, General University Hospital and Charles University in Prague, Czech Republic
Timothy Spelman
Department of Medicine, University of Melbourne, Melbourne, Australia and Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
Maria Trojano*
Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
These authors contributed equally to the manuscript:
Helmut Butzkueven*
Department of Medicine, University of Melbourne, Melbourne, Australia, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia, and Department of Neurology, Box Hill Hospital, Monash University, Box Hill, Australia
On behalf of the MSBase Study Group
Department of Medicine, University of Melbourne, Melbourne, Australia, and Department of Neurology, Royal Melbourne Hospital, Melbourne, L4 Centre, Melbourne Brain Centre at Royal Melbourne Hospital, Grattan St, Parkville VIC 3050, Australia. tomas.kalincik@unimelb.edu.au
Background:
The results of head-to-head comparisons of injectable immunomodulators (interferon β, glatiramer acetate) have been inconclusive and a comprehensive analysis of their effectiveness is needed.
Objective:
We aimed to compare, in a real-world setting, relapse and disability outcomes among patients with multiple sclerosis (MS) treated with injectable immunomodulators.
Methods:
Pairwise analysis of the international MSBase registry data was conducted using propensity-score matching. The four injectable immunomodulators were compared in six head-to-head analyses of relapse and disability outcomes using paired mixed models or frailty proportional hazards models adjusted for magnetic resonance imaging variables. Sensitivity and power analyses were conducted.
Results:
Of the 3326 included patients, 345–1199 patients per therapy were matched (median pairwise-censored follow-up was 3.7 years). Propensity matching eliminated >95% of the identified indication bias. Slightly lower relapse incidence was found among patients treated with glatiramer acetate or subcutaneous interferon β-1a relative to intramuscular interferon β-1a and interferon β-1b (p≤0.001). No differences in 12-month confirmed progression of disability were observed.
Conclusion:
Small but statistically significant differences in relapse outcomes exist among the injectable immunomodulators. MSBase is sufficiently powered to identify these differences and reflects practice in tertiary MS centres. While the present study controlled indication, selection and attrition bias, centre-dependent variance in data quality was likely.
The abstract can be seen
here.