Cohen JA, Imrey PB, Calabresi PA et al.
Cleveland Clinic Foundation, Cleveland, OH, USA.
Neurology 2009;72:535–41.
Editor’s note: Combination therapy is common practice in various autoimmune-mediated disorders and some pilot studies suggest that immunosuppressive drugs may add an additional benefit to treatment with disease-modifying interferon-
β (IFN-β). In the present randomized, semi-blind, multicenter, controlled trial, the authors recruited 313 patients with relapsing–remitting multiple sclerosis (MS). Patients were randomized in a 2 × 2 factorial design to receive treatment with IFN-βla (Avonex; Biogen Idec, Cambridge, MA, USA) in combination with either placebo, methotrexate, bimonthly intravenous methylprednisolone, or both methotrexate and methylprednisolone for 1 year.