NEW YORK (Reuters Health) - Patients with multiple sclerosis who experience breakthrough symptoms during treatment with interferon beta-1a (Avonex; Biogen, Cambridge, Massachusetts) may benefit from the addition of oral methotrexate, according to results of an open-label 6-month trial of the combination.
"The purpose of this pilot study was to determine if adding a low dose of oral methotrexate to standard MS interferon therapy was safe and efficacious in patients with breakthrough activity on monotherapy," lead investigator Dr. Peter A. Calabresi, of the University of Maryland in Baltimore, told Reuters Health.
In 15 such patients, the addition of methotrexate, 20 mg once weekly, to interferon beta-1a, 30 micrograms IM once weekly, was associated with a 44% reduction in the number of gadolinium-enhanced lesions observed on MRI (p = 0.02). There was also "a trend toward fewer exacerbations," the investigators report in the January 22nd issue of the journal Neurology.
"This trial provides preliminary evidence that the Avonex and methotrexate combination is safe and may enhance the effect of interferon on reducing active MRI lesions," Dr. Calabresi told Reuters Health.
A number of recent reports have highlighted the importance of early treatment of MS patients before significant lesions develop. "We hope that this trial will provide the groundwork and continued enthusiasm for more definitive trials of early aggressive but tolerable interventions with the available and relatively inexpensive oral immunosuppressive agents in combination with interferon," the authors write.
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