American Academy of Neurology

View all recommendations from this society

Released February 21, 2013

Don’t prescribe interferon-beta or glatiramer acetate to patients with disability from progressive, non-relapsing forms of multiple sclerosis.

Interferon-beta and glatiramer acetate do not prevent the development of permanent disability in progressive forms of multiple sclerosis. These medications increase costs and have frequent side effects that may adversely affect quality of life.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The American Academy of Neurology (AAN) established aChoosing Wisely® Working Group to develop its list of recommendations. Members of this group were selected to broadly represent varying practice settings and neurological subspecialties. Neurologists with methodological expertise in evidence-based medicine and practice guideline development were also included. The working group solicited recommendations from AAN members, which were then rated based upon their judgments of harm and benefit that would result based upon compliance with the recommendation. Based on committee voting and a literature review, candidate recommendations were sent to relevant AAN sections, committees, specialty societies and patient advocacy groups for review and comment. The working group reviewed this feedback and voted on the final Top Five recommendations, which were approved by the AAN Practice Committee and Board of Directors.

AAN’s disclosure and conflict of interest policy can be found at


Rice GPA, Incorvaia B, Munari LM, Ebers G, Polman C, D’Amico R, Parmelli E, Filippini G. Interferon in relapsing-remitting multiple sclerosis. Cochrane Database Syst Rev. 2001, Issue 4. Art. No.: CD002002. DOI: 10.1002/14651858.CD002002.

La Mantia L, Munari LM, Lovati R. Glatiramer acetate for multiple sclerosis. Cochrane Database Syst Rev. 2010, Issue 5. Art. No.: CD004678. DOI:10.1002/14651858.CD004678.pub2.

La Mantia L, Vacchi L, Di Pietrantonj C, Ebers G, Rovaris M, Fredrikson S, Filippini G. Interferon beta for secondary progressive multiple sclerosis. Cochrane Database Syst Rev. 2012, Issue 1. Art. No.: CD005181. DOI: 10.1002/14651858.CD005181.pub3.

Rojas JI, Romano M, Ciapponi A, Patrucco L, Cristiano E. Interferon Beta for Primary Progressive Multiple Sclerosis. Cochrane Database Syst Rev. 2010, Issue 1. Art. No.: CD006643. DOI: 10.1002/14651858.CD006643.pub3.