Posted by: All About MS | February 21, 2011


Injection of interferon-beta in the morning decreases flu-like syndrome in many patients with multiple sclerosis


Although it is recommended that interferon-beta (IFNβ) injections be administered in the evening.  it is possible that morning injections could more effectively decrease interleukin 6 secretion.


This study evaluated the effects of switching from an evening injection of IFNβ to a morning injection on the intensity of flu-like syndrome in patients with multiple sclerosis (MS). We performed an intervention study that consisted of a quantitative evaluation of IFNβ-related flu-like syndrome in a cohort of 105 MS patients.

Patients with persistent flu-like reactions who injected IFNβ in the evening were encouraged to switch to morning injections.  After one month we evaluated various quantitative and qualitative changes

  • severity of flu-like syndrome.
  • sleep quality.
  • antipyretic drug use).


  • Of the 98 patients
  • (93%) who injected IFNβ in the evening.
  • 88 (85%) had a persistent flu-like syndrome (the severity score was 3.92±0.26).
  • A total of 50 (57%) patients switched to morning injections.

One month after changing the injection time.

  • 29 patients (58%) reported that their flu-like syndrome was decreased.
  • 11 (24%) thought that it was unchanged and
  • 9 (18%) thought that it was increased (p=0.014).

In addition.

  • 23 patients (48%) reported improved sleep (p=0.001).  and
  • 33 (68%) patients chose to continue morning injections.  whereas
  • 17 (32%) patients switched back to evening injections (p=0.024).

Quantitative measures however indicated that there was no change in the severity of flu-like syndrome or the number of antipyretic doses taken for its management.


Morning injections qualitatively improved IFNβ-related flu-like syndrome and sleep.  A change in IFNβ injection time from evening to morning could benefit a significant proportion of patients with MS.

Source: Clinic Neurol Neurosurg
Nadjar Y.  Coutelas E.  Prouteau P.  Panzer F.  Paquet D.  Saint-Val C.  Créange A; Clinical Neurology and Neurosurgery (Jan 2011)
Changed from Medical Terminology to layman’s Terminology by Bonnie.  Bonnie is a patient with MS, not a doctor.


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