ClinicSpeak: reducing interferon injection reactions

Will reducing injection site reactions resuscitate IFNbeta as a DMT for MS? #ClinicSpeak #MSBlog #MSResearch

"Is there life in the old horse yet? The following study shows that the topical application of a cream that contains vitamin K reduces interferon-beta injections site reactions. How? Vitamin K is thought to act on the production of coagulation factors that are implicated in a reaction involved in calcium binding and in the interaction between coagulation factors and phospholipid layers in the skin. I wonder how the vitamin K is working topically on the production of the coagulation factors. I would have designed this study using the cream containing vK and compared it to the base cream without vK. This is what we call a placebo-controlled trial. I am not convinced that the vK has anything to do with the therapeutic effect of the cream; it could simply be the act of putting on the cream or the cream itself. Would you be prepared to try this cream?"




Epub: Lanzillo et al. Vitamin K cream reduces reactions at the injection site in patients with relapsing-remitting multiple sclerosis treated with subcutaneous interferon beta - VIKING study. Mult Scler. 2015. pii: 1352458514562989.


Background: MS therapy with injectable drugs is still dogged by possible local side effects (injection site pain, burning, erythema and necrosis), with the danger of poor adherence and consequently low efficacy.


Aim: We designed a 16-week prospective, double cross-over interventional study with vitamin K cream in RRMSers already treated, or starting therapy, with subcutaneous interferon IFNβ1a (VIKING study) and presenting with burning and redness at the injection site.

Methods: We enrolled 123 subjects: 66 MSers began with vitamin K (group A) and 57 without (group B).


Results: In the period of treatment there was an average reduction in injection site reactions of of 3.2 mm (CI 95% = −5.6– −0.8) compared to the period without treatment (p = 0.01).

Conclusions: We believe that our results show a beneficial effect of local vitamin K application on IFN injection sites, with an absence of side effects.

CoI: multiple

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