Interferon-β

Reactions 1076 - 5 Nov 2005 ★ Interferon-β First report of migraines in a patient with multiple sclerosis: case report A 36-year-old woman developed migraines during treatment with interferon-β for multiple sclerosis (MS). The woman, who did not have a history of chronic headache or migraine, started receiving interferon-β [dosage not stated] and experienced flu-like symptoms, including chills and muscle aches, after each injection; prophylactic paracetamol [acetaminophen] was initiated 30 minutes prior to interferon-β injections. She also reported that immediately after her interferon-β treatments, she began to experience headaches. The headaches were initially manageable, described as a sharp, throbbing pain through the eye, with associated photophobia and lasted a few hours. Over time, the headache duration, frequency and pain intensity increased. She received interferon-β at night, and her headache would last approximately 24 hours afterward; she was headache free on the days without interferon-β administration. Her headaches affected her sleep, and interferon-β administration was switched to the mornings. Despite mild sleep improvement, her headaches became more prominent in the daytime. Over time, her headaches would last 2–3 days, and interfered with activities of daily living. Minimal relief was obtained with large doses of paracetamol and ibuprofen. Subsequently, she was hospitalised with an MS exacerbation, and received IV corticosteroids and two interferon-β injections. Both interferon-β injections were associated with severe headaches that lasted almost a full day. The woman received analgesics, and migraine prophylaxis with amitriptyline was initiated. Approximately 1 week later, she remained headache-free while receiving interferon-β with concomitant amitriptyline and, after 1 month, she reported a 5-fold decrease in migraine frequency; migraine duration decreased from 2–3 days to < 1 day. Migraine intensity was also decreased and she was able to function independently. Author comment: "It was apparent that the IFN-β injections were acting as migraine triggers because of the direct cause-and-effect relationship observed." Khromov A, et al. Migraines linked to interferon-beta treatment of multiple sclerosis. American Journal of Physical Medicine and Rehabilitation 84: 644-647, No. 8, Aug 2005 - USA 801022335 » Editorial comment: A search of AdisBase and Medline did not reveal any previous case reports of migraine associated with interferon-β. The WHO Adverse Drug Reactions database contained 170 reports of migraine associated with interferon-β. 1 Reactions 5 Nov 2005 No. 1076 0114-9954/10/1076-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

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Transcript of Interferon-β

Reactions 1076 - 5 Nov 2005

★Interferon-βFirst report of migraines in a patient with multiplesclerosis: case report

A 36-year-old woman developed migraines duringtreatment with interferon-β for multiple sclerosis (MS).

The woman, who did not have a history of chronic headacheor migraine, started receiving interferon-β [dosage not stated]and experienced flu-like symptoms, including chills andmuscle aches, after each injection; prophylactic paracetamol[acetaminophen] was initiated 30 minutes prior to interferon-βinjections. She also reported that immediately after herinterferon-β treatments, she began to experience headaches.The headaches were initially manageable, described as asharp, throbbing pain through the eye, with associatedphotophobia and lasted a few hours. Over time, the headacheduration, frequency and pain intensity increased. She receivedinterferon-β at night, and her headache would lastapproximately 24 hours afterward; she was headache free onthe days without interferon-β administration. Her headachesaffected her sleep, and interferon-β administration wasswitched to the mornings. Despite mild sleep improvement,her headaches became more prominent in the daytime. Overtime, her headaches would last 2–3 days, and interfered withactivities of daily living. Minimal relief was obtained with largedoses of paracetamol and ibuprofen. Subsequently, she washospitalised with an MS exacerbation, and received IVcorticosteroids and two interferon-β injections. Bothinterferon-β injections were associated with severe headachesthat lasted almost a full day.

The woman received analgesics, and migraine prophylaxiswith amitriptyline was initiated. Approximately 1 week later,she remained headache-free while receiving interferon-β withconcomitant amitriptyline and, after 1 month, she reported a5-fold decrease in migraine frequency; migraine durationdecreased from 2–3 days to < 1 day. Migraine intensity wasalso decreased and she was able to function independently.

Author comment: "It was apparent that the IFN-βinjections were acting as migraine triggers because of thedirect cause-and-effect relationship observed."Khromov A, et al. Migraines linked to interferon-beta treatment of multiplesclerosis. American Journal of Physical Medicine and Rehabilitation 84: 644-647,No. 8, Aug 2005 - USA 801022335

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of migraine associated withinterferon-β. The WHO Adverse Drug Reactions databasecontained 170 reports of migraine associated with interferon-β.