To date, there have only been two comparative drug studies in MS, and only one of these, the EVIDENCE trial, had good quality (blinded) data collection. This comparison of interferon-beta-la at 30 mcg intramuscularly (IM) weekly (Avonex) to 44 mcg three times weekly (Rebif) was a single blind design study. The study did show superior results at 6, 12, and 16 months in favor of the higher dose (Rebif). Interestingly, the data from the earlier pivotal studies of both drugs showed similar outcomes in patients completing 2 years, as the investigators reported. It would appear that in the short term, at least, early institution of high-dose (44 mcg three times weekly) interferon-beta-la (Rebif) is more efficacious than low dose (30 micrograms once weekly) (Avonex).
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