Multiple sclerosis (MS) peak prevalence has shifted towards older age groups owing to declining premature mortality rates, yet the disease course of MS in older patients is poorly understood in terms of modern clinical practice. Thus, we re-analysed data from BEACON (BEtaferon prospective study on Adherence, COping and Nurse support), an international, non-interventional, prospective study of patients with MS and initiating interferon beta-1b (Betaferon) treatment within 6 months before study entry.
To assess patient characteristics and treatment response in the age ranges of 41–50 and >50 years, to better define MS disease course and treatment outcomes in older patients.
The BEACON study observational period lasted 2 years, with visits/assessments every 6 months. Assessments included disease history and course, annualized relapse rate (ARR), Expanded Disability Scale Score (EDSS), treatment adherence, Hospital Anxiety and Depression Scale (HADS), and adverse events.
Intention-to-treat (ITT) patients (any post-baseline visit) aged 41–50 (n=327) and >50 years (n=154), had mean (SD) ages at baseline of 45.1 (2.8) and 56.2 (4.2) years, respectively, and duration of MS since onset of symptoms of 3.9 (5.2) and 5.9 (7.1) years, respectively. The proportion of patients with confirmed relapsing–remitting MS (RRMS) and secondary progressive MS (SPMS) diagnoses at baseline was similar for those aged 41–50 years (96.3 and 3.7%) and >50 years (94.9 and 5.1%), respectively. The ARR during the 2 years before study start was 0.93 (0.48) vs 0.86 (0.54) for the 41–50 and >50 years groups, respectively, and during the study period the ARR was 0.20 (1.09) vs 0.07 (0.37), respectively. At last visit, mean (SD) HADS anxiety scores were 8.0 (4.5) and 7.5 (4.2) in the 41–50 and >50 years age groups, respectively, and likewise HADS depression scores were 6.4 (4.0) and 7.0 (4.1), respectively. The proportion with any adverse events and any serious adverse events was 15.0 and 4.2% in the 41–50 years group and 19.6 and 1.3% in the >50 years group, respectively.
MS disease activity was similar at baseline in the two age groups. Decreases in ARR for both age groups during the study compared favorably with ARR in the 2 prior years. Interferon beta-1b appears to be effective and well tolerated in middle age and older patients with MS above 40 and above 50 years.