Interferon-Beta-Induced Headache in Patients with Multiple Sclerosis: Frequency and Characterization

Interferon-Beta-Induced Headache in Patients with Multiple Sclerosis: Frequency and Characterization

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Alaa Elmazny, Sherif M Hamdy, Maged Abdel-Naseer, Nevin M Shalaby, Hatem S Shehata, Nirmeen A Kishk, Mona A Nada, Husam S Mourad, Mohamed I Hegazy, Ahmed Abdelalim, Sandra M Ahmed, Ghada Hatem, Amr M Fouad, Hadel Mahmoud, Amr Hassan Neurology Department, Faculty of Medicine, Cairo University, Cairo, EgyptCorrespondence: Hatem S ShehataNeurology Department, Cairo University, 23 Amin Samy Street – Kasr Alaini Street, Cairo, EgyptTel +2011124444179Fax +20227927795Email [email protected]: Studies have shown that interferon-beta (IFN-β) treatment is associated with headaches in patients with multiple sclerosis (MS).Headaches can affect ashley furniture porter b697-92 (porter 3-drawer nightstand) quality of life and overall function of patients with MS.

We examined the frequency, relationships, patterns, and characteristics of headaches in response to IFN-β in patients with relapsing-remitting multiple sclerosis (RRMS).Patients and Methods: This study was a prospective, longitudinal analysis with 1-year follow-up.The study comprised 796 patients with RRMS treated with IFN-β (mean age 30.84± 8.

98 years) at 5 tertiary referral center outpatient clinics in Egypt between January 2015 and December 2017.Headaches were diagnosed according to the International Classification of Headache Disorders ICHD-3 (beta version), and data were collected through an interviewer-administered Arabic-language-validated questionnaire with an addendum specifically designed to investigate the temporal relationship between commencement of interferon treatment, and headache onset and characteristics.Results: Two hundred seventy-six patients had pre-existing headaches, and 356 experienced de novo headaches.Of 122 patients who experienced headaches before IFN-β treatment, 55 reported headaches that worsened following onset of IFN-β treatment.

In patients with post-IFN-β headaches, 329 had headaches that persisted for > 3 months, 51 had chronic headaches, and 278 had episodic headaches, and 216 of these patients required preventive therapies.Univariate analysis showed a > 6- and an approximately 5-fold increased risk of headache among those treated with intramuscular (IM) INF-β-1a (OR 6.51; 95% CI: 3.73– 10.

01; P-value < 0.0001) and 44 μg of SC INF-β-1a (OR 5.44; 95% CI: 3.15– 9.

37; P-value < 0.0001), respectively, compared with that in patients who received 22 μg of SC INF-β-1a.Conclusion: Interferon-β therapy aggravated pre-existing headaches and caused primary headaches in concrete fire table hidden propane tank patients with MS.Headache risk was greater following treatment with IM INF-β-1a and 44 μg SC INF-β-1a.

Keywords: headache, interferon-beta, multiple sclerosis.