BACKGROUND: Although it is recommended that interferon-beta (IFNβ) injections be administered in the evening, it is possible that morning injections could more effectively decrease interleukin 6 secretion. METHODS: This study evaluated the effects of switching from an evening injection of IFNβ to a morning injection on the intensity of flu-like syndrome in patients with multiple sclerosis (MS). We performed an intervention study that consisted of a quantitative evaluation of IFNβ-related flu-like syndrome in a cohort of 105 MS patients. Patients with persistent flu-like reactions who injected IFNβ in the evening were encouraged to switch to morning injections. After one month, we evaluated various quantitative and qualitative changes (e.g., severity of flu-like syndrome, sleep quality, antipyretic drug use). RESULTS: Of the 98 patients (93%) who injected IFNβ in the evening, 88 (85%) had a persistent flu-like syndrome (the severity score was 3.92±0.26). A total of 50 (57%) patients switched to morning injections. One month after changing the injection time, 29 patients (58%) reported that their flu-like syndrome was decreased, 11 (24%) thought that it was unchanged and 9 (18%) thought that it was increased (p=0.014). In addition, 23 patients (48%) reported improved sleep (p=0.001), and 33 (68%) patients chose to continue morning injections, whereas 17 (32%) patients switched back to evening injections (p=0.024). Quantitative measures, however, indicated that there was no change in the severity of flu-like syndrome or the number of antipyretic doses taken for its management. CONCLUSION: Morning injections qualitatively improved IFNβ-related flu-like syndrome and sleep. A change in IFNβ injection time from evening to morning could benefit a significant proportion of patients with MS.
BACKGROUND: Although it is recommended that interferon-beta (IFNβ) injections be administered in the evening, it is possible that morning injections could more effectively decrease interleukin 6 secretion. METHODS: This study evaluated the effects of switching from an evening injection of IFNβ to a morning injection on the intensity of flu-like syndrome in patients with multiple sclerosis (MS). We performed an intervention study that consisted of a quantitative evaluation of IFNβ-related flu-like syndrome in a cohort of 105 MS patients. Patients with persistent flu-like reactions who injected IFNβ in the evening were encouraged to switch to morning injections. After one month, we evaluated various quantitative and qualitative changes (e.g., severity of flu-like syndrome, sleep quality, antipyretic drug use). RESULTS: Of the 98 patients (93%) who injected IFNβ in the evening, 88 (85%) had a persistent flu-like syndrome (the severity score was 3.92±0.26). A total of 50 (57%) patients switched to morning injections. One month after changing the injection time, 29 patients (58%) reported that their flu-like syndrome was decreased, 11 (24%) thought that it was unchanged and 9 (18%) thought that it was increased (p=0.014). In addition, 23 patients (48%) reported improved sleep (p=0.001), and 33 (68%) patients chose to continue morning injections, whereas 17 (32%) patients switched back to evening injections (p=0.024). Quantitative measures, however, indicated that there was no change in the severity of flu-like syndrome or the number of antipyretic doses taken for its management. CONCLUSION: Morning injections qualitatively improved IFNβ-related flu-like syndrome and sleep. A change in IFNβ injection time from evening to morning could benefit a significant proportion of patients with MS.
Authors: Mary L Filipi; Jill Beavin; Raquel T Brillante; Kathleen Costello; Gail C Hartley; Kay Hartley; Marie Namey; Shirley O'Leary; Gina Remington Journal: Int J MS Care Date: 2014
Authors: Hanne Marie Bøe Lunde; Tommy F Aae; William Indrevåg; Jan Aarseth; Bjørn Bjorvatn; Kjell-Morten Myhr; Lars Bø Journal: PLoS One Date: 2012-11-14 Impact factor: 3.240
Authors: James C Walton; William H Walker; Jacob R Bumgarner; O Hecmarie Meléndez-Fernández; Jennifer A Liu; Heather L Hughes; Alexis L Kaper; Randy J Nelson Journal: Clin Pharmacol Ther Date: 2020-11-29 Impact factor: 6.903