Frequency and severity of headache is worsened by Interferon‐β therapy in patients with multiple sclerosis

Patti F, Nicoletti A, Pappalardo A, Castiglione A, Lo Fermo S, Messina S, D’Amico E, Cimino V, Zappia M. Frequency and severity of headache is worsened by Interferon-β therapy in patients with multiple sclerosis. Acta Neurol Scand: 2012: 125: 91–95. © 2011 John Wiley & Sons A/S. Background –  The relationship between multiple sclerosis (MS) and headache (HA) is not well known. It was reported that interferon-beta (IFNβ) could induce or worsen HA. Objective –  To evaluate the impact of IFNβ treatment on HA and the relationship between HA and the various commercial preparations of IFNβ in mildly disabled patients with MS. Methods –  A specific questionnaire was administered to 357 relapsing-remitting MS patients. Characteristics of HAs were considered, including the temporal relationships with IFNβ administration. Results –  One hundred and seventeen patients were treated with weekly intramuscular injections of interferon IFNβ-1a (Avonex®), 84 with subcutaneous injections of IFNβ-1b (Betaferon®) every other day, 48 and 108 with three times weekly subcutaneous injections of IFNβ-1a (Rebif®) 22 mcg or IFNβ-1a (Rebif®) 44 mcg, respectively. Three hundred and fourteen patients were affected by HA, and among them, 219 patients suffered of pre-existing HA. In this latter group, 121 subjects (55%) noted a worsening of their HA after starting IFNβ therapy; this was more frequently reported by patients treated with Avonex® and Rebif® 44. Ninety-five patients experienced new HA. Conclusion –  IFNβ treatment could worsen HA in patients with pre-existing HA or cause the appearance of new HA. Among different IFNβ preparations, Rebif® 44 and Avonex® seemed to be more cephalalgic than the other drugs.