Document Type : Review Article


1 Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 Multiple Sclerosis Research Center, Neuroscience institute, Tehran University of Medical Sciences, Tehran, Iran


Background: Glatiramer acetate (GA) and Interferon (IFN) beta-1a are used as first-line disease-modifying treatments for multiple sclerosis (MS). In this systematic review, we summarized case reports and case series of adverse side effects of GA and IFN beta-1a in MS patients.
Methods: Without any restrictions, PubMed, Scopus, Web of Sciences, and Embase databases, and gray literature were systemically searched until June 2022. Articles were screened and data were extracted based on a predefined table by two independent reviewers. The risk of bias was assessed using the Joanna Briggs Institute (JBI) tool.
Results: We identified 2103 records from the preliminary search. After deduplication and screening, 172 articles were included in the systematic review. In total, 229 individuals (52 men, 173 women, and 4 unknown) were included in the study. The most common adverse events were cutaneous (32.75%), hepatic (13.54%), allergic (8.3%), and neurological (5.68%) side effects. Furthermore, most reported side effects were related to autoimmune diseases or hypersensitivity reactions.
Conclusion: GA and IFN beta-1a are associated with several side effects which may be related to the immunomodulatory function of medication or other injection-related reactions.


  1. Orton SM, Herrera BM, Yee IM, Valdar W, Ramagopalan SV, Sadovnick AD, et al. Sex ratio of multiple sclerosis in Canada: A longitudinal study. Lancet Neurol 2006; 5(11): 932-6.
  2. Walton C, King R, Rechtman L, Kaye W, Leray E, Marrie RA, et al. Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Mult Scler 2020; 26(14): 1816-21.
  3. Dhib-Jalbut S, Marks S. Interferon-beta mechanisms of action in multiple sclerosis. Neurology 2010; 74(Suppl 1): S17-S24.
  4. Racke MK, Lovett-Racke AE, Karandikar NJ. The mechanism of action of glatiramer acetate treatment in multiple sclerosis. Neurology 2010; 74(Suppl 1): S25-S30.
  5. Schrempf W, Ziemssen T. Glatiramer acetate: Mechanisms of action in multiple sclerosis. Autoimmun Rev 2007; 6(7): 469-75.
  6. Markowitz CE. Interferon-beta: Mechanism of action and dosing issues. Neurology 2007; 68(24 Suppl 4): S8-11.
  7. Pozzilli C, Koudriavtseva T. Interferon beta 1a. Baillieres Clin Neurol 1997; 6(3): 481-93.
  8. Arnon R, Aharoni R. Glatiramer acetate: From bench to bed and back. Isr Med Assoc J 2019; 21(3): 151-7.
  9. Walther EU, Hohlfeld R. Multiple sclerosis: Side effects of interferon beta therapy and their management. Neurology 1999; 53(8): 1622-7.
  10. McGraw CA, Lublin FD. Interferon beta and glatiramer acetate therapy. Neurotherapeutics 2013; 10(1): 2-18.
  11. Balak DM, Hengstman GJ, Cakmak A, Thio HB. Cutaneous adverse events associated with disease-modifying treatment in multiple sclerosis: A systematic review. Mult Scler 2012; 18(12): 1705-17.
  12. Ben-Amor AF, Trochanov A, Fischer TZ. Cumulative review of thrombotic microangiopathy, thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome reports with subcutaneous interferon beta-1a. Adv Ther 2015; 32(5): 445-54.
  13. Munn Z, Barker TH, Moola S, Tufanaru C, Stern C, McArthur A, et al. Methodological quality of case series studies: An introduction to the JBI critical appraisal tool. JBI Evid Synth 2020; 18(10): 2127-33.
  14. Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetc R, et al. Systematic Reviews of Etiology and Risk. In: Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis. Adelaide, Australia: JBI; 2020.
  15. Aharoni R, Teitelbaum D, Sela M, Arnon R. Copolymer 1 induces T cells of the T helper type 2 that crossreact with myelin basic protein and suppress experimental autoimmune encephalomyelitis. Proc Natl Acad Sci USA 1997; 94(20): 10821-6.
  16. Miller A, Shapiro S, Gershtein R, Kinarty A, Rawashdeh H, Honigman S, et al. Treatment of multiple sclerosis with copolymer-1 (Copaxone): Implicating mechanisms of Th1 to Th2/Th3 immune-deviation. J Neuroimmunol 1998; 92(1-2): 113-21.
  17. Buttmann M, Goebeler M, Toksoy A, Schmid S, Graf W, Berberich-Siebelt F, et al. Subcutaneous interferon-beta injections in patients with multiple sclerosis initiate inflammatory skin reactions by local chemokine induction. J Neuroimmunol 2005; 168(1-2): 175-82.
  18. Kluger N, Thouvenot E, Camu W, Guillot B. Cutaneous adverse events related to glatiramer acetate injection (copolymer-1, Copaxone). J Eur Acad Dermatol Venereol 2009; 23(11): 1332-3.
  19. Vlahova L, Kretschmer L, Schon MP, Mossner R. Embolia cutis medicamentosa after subcutaneous injection with glatiramer acetate. Case Rep Dermatol 2021; 13(1): 114-20.
  20. Koontz D, Alshekhlee A. Embolia cutis medicamentosa following interferon beta injection. Mult Scler 2007; 13(9): 1203-4.
  21. Harde V, Schwarz T. Embolia cutis medicamentosa following subcutaneous injection of glatiramer acetate. J Dtsch Dermatol Ges 2007; 5(12): 1122-3.
  22. Kimbrough DJ, Newsome SD. Case report: Two cases of Nicolau syndrome associated with glatiramer acetate. Int J MS Care 2017; 19(3): 148-50.
  23. Esme P, Gahramanov I, Akincioglu E, Akoglu G. Nicolau syndrome following subcutaneous glatiramer acetate injection: A case report and review of the literature. Indian J Pharmacol 2021; 53(6): 489-92.
  24. Minciullo PL, Calapai G, Gangemi S. Flare up reaction during provocation test to glatiramer acetate in a patient with allergy to interferon beta1a. Allergy Asthma Immunol Res 2014; 6(5): 467-9.
  25. Sanchez-Gonzalez MJ, Barbarroja-Escudero J, Antolin-Amerigo D, Rodriguez-Rodriguez M, Pericet-Fernandez L, Velez D, et al. Flare-up reaction in the inoculation drug sites by glatiramer acetate: First case described. Allergol Int 2016; 65(4): 469-71.
  26. Watkins CE, Litchfield J, Youngberg G, Leicht SS, Krishnaswamy G. Glatiramer acetate-induced lobular panniculitis and skin necrosis. Cutis 2015; 95(3): E26-E30.
  27. Macbeth AE, Kendall BR, Smith A, Saldanha G, Harman KE. Calcified subcutaneous nodules: A long-term complication of interferon beta-1a therapy. Br J Dermatol 2007; 157(3): 624-5.
  28. Haltmeier S, Yildiz M, Muller S, Anliker MD, Heinzerling L. Contact dermatitis induced by glatiramer acetate. Mult Scler 2011; 17(11): 1390-2.
  29. Longmuir R, Lee AG, Rouleau J. Cotton wool spots associated with interferon beta-1 alpha therapy. Semin Ophthalmol 2007; 22(1): 49-53.
  30. Kolb-Maurer A, Goebeler M, Maurer M. Cutaneous adverse events associated with interferon-beta treatment of multiple sclerosis. Int J Mol Sci 2015; 16(7): 14951-60.
  31. Howard LG, Bomprezzi R. Demyelinating disease and psoriasis: Interferon versus dimethyl fumarate. J Neurol Sci 2014; 343(1-2): 230-1.
  32. Frohman EM, Brannon K, Alexander S, Sims D, Phillips JT, O'Leary S, et al. Disease modifying agent related skin reactions in multiple sclerosis: Prevention, assessment, and management. Mult Scler 2004; 10(3): 302-7.
  33. Edgar CM, Brunet DG, Fenton P, McBride EV, Green P. Lipoatrophy in patients with multiple sclerosis on glatiramer acetate. Can J Neurol Sci 2004; 31(1): 58-63.
  34. Hwang L, Orengo I. Lipoatrophy associated with glatiramer acetate injections for the treatment of multiple sclerosis. Cutis 2001; 68(4): 287-8.
  35. Beiske AG, Myhr KM. Lipoatrophy: A non-reversible complication of subcutaneous interferon-beta 1a treatment of multiple sclerosis. J Neurol 2006; 253(3): 377-8.
  36. Weise G, Hupp M, Kerstan A, Buttmann M. Lobular panniculitis and lipoatrophy of the thighs with interferon-ss1a for intramuscular injection in a patient with multiple sclerosis. J Clin Neurosci 2012; 19(9): 1312-3.
  37. Ball NJ, Cowan BJ, Moore GR, Hashimoto SA. Lobular panniculitis at the site of glatiramer acetate injections for the treatment of relapsing-remitting multiple sclerosis. A report of two cases. J Cutan Pathol 2008; 35(4): 407-10.
  38. Ball NJ, Cowan BJ, Hashimoto SA. Lobular panniculitis at the site of subcutaneous interferon beta injections for the treatment of multiple sclerosis can histologically mimic pancreatic panniculitis. A study of 12 cases. J Cutan Pathol 2009; 36(3): 331-7.
  39. Garcia F, V, Dauden E, Sanchez J, Fraga J, Ramo C, Garcia-Diez A. Local reactions associated with subcutaneous injections of both beta-interferon 1a and 1b. Acta Derm Venereol 2001; 81(2): 152.
  40. Soos N, Shakery K, Mrowietz U. Localized panniculitis and subsequent lipoatrophy with subcutaneous glatiramer acetate (Copaxone) injection for the treatment of multiple sclerosis. Am J Clin Dermatol 2004; 5(5): 357-9.
  41. Bosca I, Bosca M, Belenguer A, Evole M, Hernandez M, Casanova B, et al. Necrotising cutaneous lesions as a side effect of glatiramer acetate. J Neurol 2006; 253(10): 1370-1.
  42. McDaniel C, Trankiem C. Necrotizing fasciitis in a patient on long-term intramuscular interferon-beta for multiple sclerosis: A case report. JBJS Case Connect 2020; 10(1): e0288.
  43. Carotenuto A, Iodice R, Barbato F, Orefice NS, Orefice G. Necrotizing skin lesion and radial nerve palsy in a patient treated with glatiramer acetate. J Neurol Sci 2013; 331(1-2): 172-3.
  44. Feldmann R, Schierl M, Rauschka H, Sator PG, Breier F, Steiner A. Necrotizing skin lesions with involvement of muscle tissue after subcutaneous injection of glatiramer acetate. Eur J Dermatol 2009; 19(4): 385.
  45. Lopez-Lerma I, Iranzo P, Herrero C. New-onset psoriasis in a patient treated with interferon beta-1a. Br J Dermatol 2009; 160(3): 716-7.
  46. Mott SE, Pena ZG, Spain RI, White KP, Ehst BD. Nicolau syndrome and localized panniculitis: a report of dual diagnoses with an emphasis on morphea profunda-like changes following injection with glatiramer acetate. J Cutan Pathol 2016; 43(11): 1056-61.
  47. Koller S, Kranke B. Nicolau syndrome following subcutaneous glatiramer-acetate injection. J Am Acad Dermatol 2011; 64(2): e16-e17.
  48. Cicek D, Kandi B, Oguz S, Cobanoglu B, Bulut S, Saral Y. An urticarial vasculitis case induced by glatiramer acetate. J Dermatolog Treat 2008; 19(5): 305-7.
  49. Kocer B, Nazliel B, Oztas M, Batur HZ. Vitiligo and multiple sclerosis in a patient treated with interferon beta-1a: A case report. Eur J Neurol 2009; 16(4): e78-e79.
  50. Serarslan G, Okuyucu E, Melek I, Hakverdi S, Duman T. Widespread maculopapular rash due to intramuscular interferon beta-1a during the treatment of multiple sclerosis. Mult Scler 2008; 14(2): 259-61.
  51. Guijarro C, Benito-Leon J, Bermejo-Pareja F. Widespread urticaria due to intramuscular interferon beta-1a therapy for multiple sclerosis. Neurol Sci 2011; 32(2): 309-11.
  52. Fabi S, Peterson JD, Goldman M. Localized lipoatrophy following glatiramer acetate injections: A case report of treatment with intralesional normal saline. Cosmetic Dermatology 2011; 24(10): 466-8.
  53. Mazzeo L, Ricciardi L, Fazio MC, Fogliani O, Fedele R, Ferlazzo E, et al. Severe urticaria due to recombinant interferon beta-1a. Br J Dermatol 2003; 148(1): 172.
  54. Peterson E, Steuer A, Franco L, Nolan MA, Lo SK, Franks AG. Morphoea induced by treatment with interferon beta-1a. Br J Dermatol 2020; 182(1): 244-6.
  55. Aviv B, Yaron Z, Anat A, Sharon B. Patterns of local site reactions to subcutaneous glatiramer acetate treatment of multiple sclerosis: A clinicopathological study. Int J Clin Exp Pathol 2018; 11(6): 3126-33.
  56. Tsivgoulis G, Papadimitropoulos GN, Katsanos AH, Zompola C, Safouris A, Kargiotis O, et al. Teaching NeuroImages: Interferon-induced psoriasis flare in a multiple sclerosis case remits with dimethyl fumarate. Neurology 2017; 89(15): e188-e189.
  57. Zecca C, Mainetti C, Blum R, Gobbi C. Recurrent Nicolau syndrome associated with subcutaneous glatiramer acetate injection--a case report. BMC Neurol 2015; 15: 249.
  58. Bonaci-Nikolic B, Jeremic I, Andrejevic S, Sefik-Bukilica M, Stojsavljevic N, Drulovic J. Anti-double stranded DNA and lupus syndrome induced by interferon-beta therapy in a patient with multiple sclerosis. Lupus 2009; 18(1): 78-80.
  59. Crispin JC, Diaz-Jouanen E. Systemic lupus erythematosus induced by therapy with interferon-beta in a patient with multiple sclerosis. Lupus 2005; 14(6): 495-6.
  60. Bahri DM, Khiari H, Essouri A, Laadhar L, Zaraa I, Mrabet A, et al. Systemic lupus erythematosus induced by interferon beta1 therapy in a patient with multiple sclerosis. Fundam Clin Pharmacol 2012; 26(2): 210-1.
  61. Bezalel SA, Strober BE, Ferenczi K. Interferon beta-1a-induced morphea. JAAD Case Rep 2015; 1(1): 15-7.
  62. Somani AK, Swick AR, Cooper KD, McCormick TS. Severe dermatomyositis triggered by interferon beta-1a therapy and associated with enhanced type I interferon signaling. Arch Dermatol 2008; 144(10): 1341-9.
  63. Pacheco MF, Jacobe H, Eagar TN, Stuve O. Reversible alopecia associated with glatiramer acetate. Arch Neurol 2010; 67(9): 1154.
  64. Ozuguz P, Kacar SD, Karaca S, Tokyol C. A case of septal panniculitis secondary to interferon treatment. Cutan Ocul Toxicol 2014; 33(4): 351-2.
  65. Nousari HC, Kimyai-Asadi A, Tausk FA. Subacute cutaneous lupus erythematosus associated with interferon beta-1a. Lancet 1998; 352(9143): 1825-6.
  66. Vera-Iglesias E, Garcia-Arpa M, Sanchez-Caminero P. Halo nevi associated with interferon beta-1a therapy. Actas Dermosifiliogr 2012; 103(1): 75-6.
  67. Thouvenot E, Hillaire-Buys D, Bos-Thompson MA, Rigau V, Durand L, Guillot B, et al. Erythema nodosum and glatiramer acetate treatment in relapsing-remitting multiple sclerosis. Mult Scler 2007; 13(7): 941-4.
  68. Ozden MG, Erel A, Erdem O, Oztas MO. Dermal fibrosis and cutaneous necrosis after recombinant interferon-beta1a injection in a multiple sclerosis patient. J Eur Acad Dermatol Venereol 2005; 19(1): 112-3.
  69. Gil M, Chizzolini C, Kaya G, Hauser C. Erythema elevatum et diutinum, multiple sclerosis and interferon beta. Dermatology 2004; 209(1): 75-6.
  70. Christopher V, Scolding N, Przemioslo RT. Acute hepatitis secondary to interferon beta-1a in multiple sclerosis. J Neurol 2005; 252(7): 855-6.
  71. Kozielewicz D, Pawlowska M. Acute liver failure and liver transplantation in a patient with multiple sclerosis treated with interferon beta. Neurol Neurochir Pol 2015; 49(6): 451-5.
  72. Duchini A. Autoimmune hepatitis and interferon beta-1a for multiple sclerosis. Am J Gastroenterol 2002; 97(3): 767-8.
  73. Yamaguchi H, Sakai K, Goto Y, Yamada M. Autoimmune hepatitis induced by a single injection of interferon-beta 1a in a patient with multiple sclerosis. J Neurol 2018; 265(6): 1469-71.
  74. Mishra A, Guindi M, Kandel G, Streutker CJ. Autoimmune hepatitis-like reaction developing in a patient treated with interferon-beta1a. Histopathology 2015; 66(4): 605-7.
  75. Yamazaki Y, Suzuki A, Hirayanagi K, Tsukagoshi Y, Uehara R, Horiguchi K, et al. An Autopsy Case of Fulminant Hepatitis in a Patient with Multiple Sclerosis Treated by Interferon-Beta-1a. Intern Med 2017; 56(14): 1897-901.
  76. Sabatino JJ, Mehta NJ, Kakar S, Zamvil SS, Cree BAC. Acute liver injury in a Glatopa-treated patient with MS. Neurol Neuroimmunol Neuroinflamm 2017; 4(4): e368.
  77. Liao MF, Yen SC, Chun-Yen L, Rong-Kuo L. Delayed Liver Function Impairment Secondary to Interferon beta-1a Use in Multiple Sclerosis. Case Rep Neurol 2013; 5(2): 130-4.
  78. Sinagra E, Raimondo D, Cottone S, Guddo F, Gabriele RA, Amvrosiadis G, et al. Does glatiramer acetate provoke hepatitis in multiple sclerosis? Mult Scler Relat Disord 2014; 3(2): 266-8.
  79. Byrnes V, Afdhal N, Challies T, Greenstein PE. Drug induced liver injury secondary to interferon-beta (IFN-beta) in multiple sclerosis. Ann Hepatol 2006; 5(1): 56-9.
  80. Michels S, Zizer E, Barth TF, Wassner A, Fangerau T, Taranu D, et al. Drug-induced liver injury associated with the biosimilar glatiramer acetate (Clift(R)). Mult Scler Relat Disord 2020; 40: 101948.
  81. Onmez A, Eminler AT, Ergenc H, Baykara M, Uslan I, Tamer A. Drug-induced liver injury by glatiramer acetate used for treatment of multiple sclerosis: A case report. J Investig Med High Impact Case Rep 2013; 1(4): 2324709613517493.
  82. Pietrosi G, Mandala L, Vizzini GB, Gruttadauria S, Minervini MI, Burgio G, et al. Fulminant hepatic failure and autoimmune disorders in patient with multiple sclerosis on interferon beta 1a: A fatal combination? Transpl Int 2008; 21(5): 502-4.
  83. Yoshida EM, Rasmussen SL, Steinbrecher UP, Erb SR, Scudamore CH, Chung SW, et al. Fulminant liver failure during interferon beta treatment of multiple sclerosis. Neurology 2001; 56(10): 1416.
  84. Neumann H, Csepregi A, Sailer M, Malfertheiner P. Glatiramer acetate induced acute exacerbation of autoimmune hepatitis in a patient with multiple sclerosis. J Neurol 2007; 254(6): 816-7.
  85. Subramaniam K, Pavli P, Llewellyn H, Chitturi S. Glatiramer acetate induced hepatotoxicity. Curr Drug Saf 2012; 7(2): 186-8.
  86. Antezana A, Herbert J, Park J, Kister I. Glatiramer acetate-induced acute hepatotoxicity in an adolescent with MS. Neurology 2014; 82(20): 1846-7.
  87. Makhani N, Ngan BY, Kamath BM, Yeh EA. Glatiramer acetate-induced acute hepatotoxicity in an adolescent with MS. Neurology 2013; 81(9): 850-2.
  88. Flaire A, Carra-Dalliere C, Ayrignac X, Blanc P, Labauge P. Glatiramer acetate-induced hepatitis in a patient with multiple sclerosis. Acta Neurol Belg 2016; 116(1): 99-100.
  89. La Gioia S, Bacis G, Sonzogni A, Frigeni B, Conti MZ, Vedovello M, et al. Glatiramer acetate-induced hepatitis in a young female patient with multiple sclerosis. Mult Scler Relat Disord 2014; 3(6): 732-4.
  90. Villamil A, Mullen E, Casciato P, Gadano A. Interferon beta 1a-induced severe autoimmune hepatitis in patients with multiple sclerosis: Report of two cases and review of the literature. Ann Hepatol 2015; 14(2): 273-80.
  91. Almeida J, Sola-Valls N, Pose E, Blanco Y, Sepulveda M, Llufriu S, et al. Liver injury and glatiramer acetate, an uncommon association: Case report and literature review. Ther Adv Neurol Disord 2017; 10(11): 367-72.
  92. Francis GS, Kaplowitz N, Alteri E. Liver injury associated with the beta-interferons for MS. Neurology 2004; 63(6): 1142-3.
  93. Grieco A, Montalto M, Vero V, Maria VF, Gasbarrini G. Severe acute hepatitis after resumption of interferon-Beta therapy for multiple sclerosis: A word of caution. Am J Gastroenterol 2007; 102(11): 2606-7.
  94. Kowalec K, Yoshida EM, Traboulsee A, Carleton B, Tremlett H. Suspected autoimmune hepatitis and primary biliary cirrhosis unmasked by interferon-beta in a multiple sclerosis patient. Mult Scler Relat Disord 2013; 2(1): 57-9.
  95. Pulicken M, Koteish A, DeBusk K, Calabresi PA. Unmasking of autoimmune hepatitis in a patient with MS following interferon beta therapy. Neurology 2006; 66(12): 1954-5.
  96. Baumgartner A, Stich O, Rauer S. Anaphylactic reaction after injection of glatiramer acetate (Copaxone(R)) in patients with relapsing-remitting multiple sclerosis. Eur Neurol 2011; 66(6): 368-70.
  97. Wohrl S, Wantke F, Hemmer W. Anaphylaxis to glatiramer acetate. The Open Allergy Journal 2015; 8(1): 23-5.
  98. Crestani E, Lee J, Gorman M, Castells M, Dioun Broyles AF. IgE-mediated hypersensitivity reaction and desensitization to glatiramer acetate in a pediatric patient. Pediatr Allergy Immunol 2014; 25(8): 821-3.
  99. Marco-Martin G, Tornero P, Prieto A, La RA, Herrero T, Baeza ML. Immediate reactions with glatiramer acetate: Diagnosis of allergy and desensitization protocols. Neurol Clin Pract 2020; 10(2): 170-7.
  100. Mayorga C, Blazquez AB, Dona I, Gomez F, Chaves P, Sanchez-Quintero MJ, et al. Immunological mechanisms underlying delayed-type hypersensitivity reactions to glatiramer acetate. Ann Allergy Asthma Immunol 2012; 109(1): 47-51.
  101. Rauschka H, Farina C, Sator P, Gudek S, Breier F, Schmidbauer M. Severe anaphylactic reaction to glatiramer acetate with specific IgE. Neurology 2005; 64(8): 1481-2.
  102. Cortellini G, Amadori A, Comandini T, Corvetta A. Interferon beta 1a anaphylaxis, a case report. Standardization of non-irritating concentration for allergy skin tests. Eur Ann Allergy Clin Immunol 2013; 45(5): 181-2.
  103. Motta E, Golba A, Huc M, Kazibutowska Z. Development of Guillain-Barre syndrome in a patient with multiple sclerosis during treatment with glatiramer acetate. Neurol Neurochir Pol 2012; 46(2): 189-91.
  104. Frese A, Bethke F, Ludemann P, Stogbauer F. Development of myasthenia gravis in a patient with multiple sclerosis during treatment with glatiramer acetate. J Neurol 2000; 247(9): 713.
  105. Pawlitzki M, Campe C, Rolfes L, Heinze HJ, Leypoldt F, Wandinger KP, et al. Transient MOG antibody seroconversion associated with immunomodulating therapy. Mult Scler Relat Disord 2020; 37: 101420.
  106. Coraci D, Giovannini S, Loreti C, Padua L. Ulnar neuropathy after glatiramer acetate subcutaneous injection: Ultrasound findings. J Clin Pharm Ther 2019; 44(1): 140-1.
  107. Villa AM, Videla C, Garcea O, Carballal G. Incidence of antibodies in cerebrospinal fluid of patients with multiple sclerosis treated with interferon beta. Arq Neuropsiquiatr 2009; 67(3B): 900-1.
  108. Bischof A, Sprenger T. Interferon beta-associated recurrence of painful trigeminal neuropathy attributed to a multiple sclerosis plaque. J Headache Pain 2014; 15(1): 21.
  109. Lagueny A, Ouallet JC. Meralgia paresthetica after subcutaneous injection of glatiramer acetate. Muscle Nerve 2015; 52(1): 150-1.
  110. Ekstein D, Linetsky E, Abramsky O, Karussis D. Polyneuropathy associated with interferon beta treatment in patients with multiple sclerosis. Neurology 2005; 65(3): 456-8.
  111. Polman CH, Jansen PH, Jansen C, Uitdehaag BM. A rare, treatable cause of relapsing encephalopathy in an MS patient on interferon beta therapy. Neurology 2003; 61(5): 719.
  112. Strohm T, Chaudhry B, Willis MA, Shook S. Reversible cerebral vasoconstriction syndrome associated with interferon beta-1a use for multiple sclerosis. Mult Scler 2016; 22(12): 1626-8.
  113. Von RF, Abboud H, Saint VC, Brugieres P, Cesaro P. Acute demyelinating disease after interferon beta-1a treatment for multiple sclerosis. Neurology 2000; 55(9): 1416-7.
  114. Hansen T, New D, Reeve R, Donne R, Stephens W. Acute renal failure, systemic lupus erythematosus and thrombotic microangiopathy following treatment with beta-interferon for multiple sclerosis: Case report and review of the literature. NDT Plus 2009; 2(6): 466-8.
  115. Tornes L, Delgado S, Garcia-Buitrago M, Ortega MR, Rammohan KW. Focal segmental glomerulosclerosis secondary to subcutaneous interferon beta-1a treatment in a patient with multiple sclerosis. Mult Scler Relat Disord 2012; 1(3): 148-51.
  116. Capobianco M, Piccoli G, Neve Vigotti F, Scapoli P, Deagostini MC, Albera C, et al. Interferon beta-related nephropathy and interstitial lung disease: A new association and a long-term warning. Mult Scler 2014; 20(7): 889-91.
  117. Ozturk M, Basoglu F, Yilmaz M, Ozagari AA, Baybas S. Interferon beta associated nephropathy in a Multiple Sclerosis patient: A case and review. Mult Scler Relat Disord 2016; 9: 50-3.
  118. Tola MR, Caniatti LM, Gragnaniello D, Russo M, Stabellini N, Granieri E. Recurrent nephrotic syndrome in patient with multiple sclerosis treated with interferon beta-1a. J Neurol 2003; 250(6): 768-9.
  119. Evans R, Rudd P, Bass P, Harber M. Tip variant focal segmental glomerulosclerosis associated with interferon-beta treatment of multiple sclerosis. BMJ Case Rep 2014; 2014: bcr2013203077.
  120. Auty A, Saleh A. Nephrotic syndrome in a multiple sclerosis patient treated with interferon beta 1a. Can J Neurol Sci 2005; 32(3): 366-8.
  121. Yuste C, Rapalai M, Pritchard BA, Jones TJ, Tucker B, Ramakrishna SB. Nephrotic-range proteinuria on interferon-beta treatment: Immune-induced glomerulonephritis or other pathway? Clin Kidney J 2014; 7(2): 190-3.
  122. Gucev ZS, Kirovski I, Jancevska A, Popjordanova N, Tasic V. Papillorenal syndrome after Beta-interferon treatment in pregnancy. Ren Fail 2009; 31(7): 602-5.
  123. Mahe J, Meurette A, Moreau A, Vercel C, Jolliet P. Renal thrombotic microangiopathy caused by interferon beta-1a treatment for multiple sclerosis. Drug Des Devel Ther 2013; 7: 723-8.
  124. Li CG, Bono L, Tortorici C, Giammarresi C, Rotolo U. Renal thrombotic microangiopathy induced by beta-interferon. NDT Plus 2011; 4(1): 80.
  125. Almeida L, Neves M, Cardoso E, Melo A. Chronic myeloid leukaemia in two multiple sclerosis patients on interferon beta-1a. J Clin Pharm Ther 2009; 34(1): 125-7.
  126. Vieira RG, Vale TC, Rocha CF, Araujo CR, Lana-Peixoto MA. Meningioma after immunomodulation for multiple sclerosis. Arq Neuropsiquiatr 2012; 70(1): 75-6.
  127. Gama HP, Rocha AJ, Silva CJ, Mendes MF, Veiga JC, Lancellotti CL, et al. Meningioma growth during interferon beta-1A treatment for multiple sclerosis. Arq Neuropsiquiatr 2008; 66(2B): 402-4.
  128. Walker J, Smylie A, Smylie M. An association between glatiramer acetate and malignant melanoma. J Immunother 2016; 39(7): 276-8.
  129. Chiang S, Kesari NK, Bradshaw A, Chen W, Samudralwar R, Alobaidy AM, et al. Pearls & Oy-sters: CNS lymphoma in a patient with relapsing-remitting multiple sclerosis treated with interferon. Neurology 2017; 89(17): e210-e213.
  130. Blancas I, Cardenas N, Delgado M, Jurado JM, Legeren M, Villaescusa A, et al. Late relapse of non-seminomatous testicular cancer during treatment of multiple sclerosis with interferon beta-1a: A case report. Oncol Lett 2014; 8(5): 2179-82.
  131. Amaria RN, Corboy JR, Finlayson CA, Robinson WA, Borges VF. Immunomodulatory therapy in multiple sclerosis and breast cancer risk: A case report and literature review. Clin Breast Cancer 2008; 8(5): 449-52.
  132. Gerischer LM, Siebert E, Janke O, Jungehuelsing GJ, Ruprecht K. Favorable outcome of interferon-beta associated thrombotic microangiopathy following treatment with corticosteroids, plasma exchange and rituximab: A case report. Mult Scler Relat Disord 2016; 10: 63-5.
  133. Yam C, Fok A, Mclean C, Butler E, Kempster P. Interferon-beta in multiple sclerosis causing thrombotic microangiopathy. Intern Med J 2019; 49(2): 274-6.
  134. Perez EP, Sanchez de la Nieta Garcia MD, Lopez LG, Hernandez FR. Thrombotic microangiopathy and accelerated hypertension after treatment with interferon beta. Nefrologia (Engl Ed) 2018; 38(5): 564-5.
  135. Olea T, Diaz-Mancebo R, Picazo ML, Martinez-Ara J, Robles A, Selgas R. Thrombotic microangiopathy associated with use of interferon-beta. Int J Nephrol Renovasc Dis 2012; 5: 97-100.
  136. Allinovi M, Cirami CL, Caroti L, Antognoli G, Farsetti S, Amato MP, et al. Thrombotic microangiopathy induced by interferon beta in patients with multiple sclerosis: three cases treated with eculizumab. Clin Kidney J 2017; 10(5): 625-31.
  137. Heesen C, Gbadamosi J, Schoser BG, Pohlau D. Autoimmune hyperthyroidism in multiple sclerosis under treatment with glatiramer acetate--a case report. Eur J Neurol 2001; 8(2): 199.
  138. Strueby L, Nair B, Kirk A, Taylor-Gjevre RM. Arthritis and bursitis in multiple sclerosis patients treated with interferon-beta. Scand J Rheumatol 2005; 34(6): 485-8.
  139. Kreiss Y, Cohen O, Pras E, Achiron A. Subacute thyroiditis in a patient with MS treated with interferon beta-1a. Neurology 1999; 53(7): 1606.
  140. Spierer O, Leibovitch I. Recurrent orbital inflammation in a patient with multiple sclerosis treated with interferon-beta. Clin Exp Ophthalmol 2011; 39(8): 835-7.
  141. Gaetani L, Menduno PS, Cometa F, Di Gregorio M, Sarchielli P, Cagini C, et al. Retinopathy during interferon-beta treatment for multiple sclerosis: case report and review of the literature. J Neurol 2016; 263(3): 422-7.
  142. Bakri SJ, Swanson JW. Asymptomatic peripheral retinal hemorrhages as a manifestation of interferon beta 1a retinopathy. Semin Ophthalmol 2015; 30(1): 56-7.
  143. Post JW, Colleaux K. Interferon beta retinopathy in a patient with multiple sclerosis. Can J Ophthalmol 2009; 44(5): e37.
  144. Goeb JL, Cailleau A, Laine P, Etcharry-Bouyx F, Maugin D, Duverger P, et al. Acute delirium, delusion, and depression during IFN-beta-1a therapy for multiple sclerosis: A case report. Clin Neuropharmacol 2003; 26(1): 5-7.
  145. Pandya R, Patten S. Depression in multiple sclerosis associated with interferon beta-1a (Rebif). Can J Psychiatry 2002; 47(7): 686.
  146. Lana-Peixoto MA, Teixeira AL, Haase VG. Interferon beta-1a-induced depression and suicidal ideation in multiple sclerosis. Arq Neuropsiquiatr 2002; 60(3-B): 721-4.
  147. Lamotte G, Cogez J, Viader F. Interferon-beta-1a-induced psychosis in a patient with multiple sclerosis. Psychiatry Clin Neurosci 2012; 66(5): 462.
  148. Pjrek E, Winkler D, Dervic K, Aschauer H, Kasper S. Psychosis as a possible side-effect of treatment with glatiramer acetate. Int J Neuropsychopharmacol 2005; 8(3): 487-8.
  149. Kastalli S, El AS, Mourali S, Zaiem A, Daghfous R, Lakhal M. Cardiac arrhythmia induced by interferon beta-1a. Fundam Clin Pharmacol 2012; 26(2): 207-9.
  150. Michaud CJ, Bockheim HM, Nabeel M, Daum TE. Diagnosis of exclusion: A case report of probable glatiramer acetate-induced eosinophilic myocarditis. Case Rep Neurol Med 2014; 2014: 786342.
  151. Cheraghmakani H, Samaee HR, Ghazaeian M. Interferon Beta-1a Cardiomyopathy in a Patient with Multiple Sclerosis: Case Report. Mult Scler Relat Disord 2020; 44: 102219.
  152. Rodrigues S, Magro F, Soares J, Nunes AC, Lopes S, Marques M, et al. Case series: Ulcerative colitis, multiple sclerosis, and interferon-beta 1a. Inflamm Bowel Dis 2010; 16(12): 2001-3.
  153. Charach G, Grosskopf I, Weintraub M. Development of Crohn's disease in a patient with multiple sclerosis treated with copaxone. Digestion 2008; 77(3-4): 198-200.
  154. Schott E, Paul F, Wuerfel JT, Zipp F, Rudolph B, Wiedenmann B, et al. Development of ulcerative colitis in a patient with multiple sclerosis following treatment with interferon beta 1a. World J Gastroenterol 2007; 13(26): 3638-40.
  155. Tuna Y, Basar O, Dikici H, Koklu S. Rapid onset of ulcerative colitis after treatment with interferon beta1a in a patient with multiple sclerosis. J Crohns Colitis 2011; 5(1): 75-6.
  156. Ferriby D, Stojkovic T. Clinical picture: bronchiolitis obliterans with organising pneumonia during interferon beta-1a treatment. Lancet 2001; 357(9258): 751.
  157. Fok A, Williams T, McLean CA, Butler E. Interferon beta-1a long-term therapy related to pulmonary arterial hypertension in multiple sclerosis patients. Mult Scler 2016; 22(11): 1495-8.
  158. Govern EM, Judge EP, Kavanagh E, Gaine S, Lynch T. Interferon beta related pulmonary arterial hypertension; an emerging worrying entity? Mult Scler Relat Disord 2015; 4(3): 284-6.
  159. Piroddi IM, Barlascini C, Nicolini A. Severe respiratory failure due to interferon beta-related pulmonary hypertension. Am J Ther 2016; 23(5): e1275-e1276.
  160. Caravita S, Secchi MB, Wu SC, Pierini S, Paggi A. Sildenafil therapy for interferon-beta-1a-induced pulmonary arterial hypertension: A case report. Cardiology 2011; 120(4): 187-9.
  161. Halasan C, Isache C, Sands M. A case of Disseminated Herpes Zoster in a patient with Multiple Sclerosis on Glatiramer acetate. IDCases 2020; 21: e00873.
  162. Lehmann HC, Kruger K, Fink GR, Schroeter M. Progressive multifocal leukoencephalopathy after interferon beta-1a monotherapy. J Neurol 2015; 262(3): 771-3.
  163. Jerman A, Kovac D, Veceric-Haler Z, Hocevar A, Ota A, Banovic S, et al. Rhabdomyolysis and interferon-beta: Case report and short review. Clin Nephrol 2017; 88(13): 32-4.
  164. Lunemann JD, Schwarzenberger B, Kassim N, Zschenderlein R, Zipp F. Rhabdomyolysis during interferon-beta 1a treatment. J Neurol Neurosurg Psychiatry 2002; 72(2): 274.
  165. Dalbjerg SM, Tsakiri A, Frederiksen JL. Rhabdomyolysis following interferon-beta treatment in a patient with multiple sclerosis - A case report. Mult Scler Relat Disord 2016; 8: 93-5.
  166. Aslam AK, Singh T. Aplastic anemia associated with interferon beta-1a. Am J Ther 2002; 9(6): 522-3.
  167. Masuda H, Mori M, Araki N, Kuwabara S. Bilateral Foot Acrocyanosis in an Interferon-beta-treated MS Patient. Intern Med 2016; 55(3): 319.
  168. Uonaga T, Yoshida K, Harada T, Shimodahira M, Nakamura Y. Case of type 1 diabetes mellitus following interferon beta-1a treatment for multiple sclerosis. Intern Med 2012; 51(14): 1875-7.
  169. Ferguson P. Case report: Glatiramer acetate-induced serum sickness. Int J MS Care 2017; 19(5): 263-4.
  170. Viana de Andrade AC, Brito EA, Harris OM, Viana de Andrade AP, Leite MF, Pithon MM. Development of systemic sarcoidosis and xanthoma planum during multiple sclerosis treatment with interferon-beta 1a: Case Report. Int J Dermatol 2015; 54(5): e140-e145.
  171. Powell A, Myles ML, Yacyshyn E. The development of systemic sclerosis in a female patient with multiple sclerosis following beta interferon treatment. Clin Rheumatol 2008; 27(11): 1467-8.
  172. Salahudheen SM, Begam MA. Disease-modifying drug possibly linked to placental insufficiency: Severe placental complications in a pregnant woman with multiple sclerosis. Sultan Qaboos Univ Med J 2016; 16(3): e368-e370.
  173. Laird PW, Newman NJ, Yeh S. Exacerbation of Susac syndrome retinopathy by interferon Beta-1a. Arch Ophthalmol 2012; 130(6): 804-6.
  174. Eguchi J, Miyashita K, Fukamachi I, Nakajima K, Murakami M, Kawahara Y, et al. GPIHBP1 autoantibody syndrome during interferon beta1a treatment. J Clin Lipidol 2019; 13(1): 62-9.
  175. Nerrant E, Charif M, Ramay AS, Perrochia H, Patrier L, de Champfleur NM, et al. Hemolytic uremic syndrome: An unusual complication of interferon-beta treatment in a MS patient. J Neurol 2013; 260(7): 1915-6.
  176. Levesque MC, Ward FE, Jeffery DR, Weinberg JB. Interferon-beta1A-induced polyarthritis in a patient with the HLA-DRB1*0404 allele. Arthritis Rheum 1999; 42(3): 569-73.
  177. Andreassen M, Frystyk J, Miller KK, Kristensen LO. Interferon-beta treatment associated with a biochemical profile suggestive of acromegaly. A case report of a patient treated for multiple sclerosis. Scand J Clin Lab Invest 2010; 70(7): 519-22.
  178. Nolden S, Casper C, Kuhn A, Petereit HF. Jessner-Kanof lymphocytic infiltration of the skin associated with glatiramer acetate. Mult Scler 2005; 11(2): 245-8.
  179. Midgard R, Ertresvag K, Trondsen E, Spigset O. Life-threatening acute pancreatitis associated with interferon beta-1a treatment in multiple sclerosis. Neurology 2005; 65(1): 170-1.
  180. de Santi L, Costantini MC, Annunziata P. Long time interval between multiple sclerosis onset and occurrence of primary Sjogren's syndrome in a woman treated with interferon-beta. Acta Neurol Scand 2005; 112(3): 194-6.
  181. Kawahara Y, Yamashita T, Ohta Y, Sato K, Tsunoda K, Takemoto M, et al. Marked hypertriglyceridemia induced by interferon-beta1a therapy in a clinically isolated syndrome patient. J Neurol Sci 2017; 373: 144-6.
  182. de MS, Borruat FX, Ambresin A. Peripheral Bilateral Telangiectasiae in Multiple Sclerosis Patients Treated with Interferon B1a. Klin Monbl Augenheilkd 2016; 233(4): 438-40.
  183. Kinyas S, Esgin H. Peripheral Vasculitis, Intermediate Uveitis and Interferon Use in Multiple Sclerosis. Turk J Ophthalmol 2016; 46(1): 41-3.
  184. Chakravarty SD, Harris ME, Schreiner AM, Crow MK. Sarcoidosis triggered by interferon-Beta treatment of multiple sclerosis: A case report and focused literature review. Semin Arthritis Rheum 2012; 42(2): 206-12.
  185. Kumar N, Rodriguez M. Scleromyxedema in a patient with multiple sclerosis and monoclonal gammopathy on interferon beta-1a. Mult Scler 2004; 10(1): 85-6.
  186. Cosso C, Cosso R, Cimmino MA. Secondary hemophagocytic lymphohistiocytosis possibly induced by interferon beta-1a therapy. Reumatismo 2013; 65(5): 253-5.
  187. Diamantopoulos AP, Hetland H, Hansen AE, Myklebust G. Severe deterioration of newly diagnosed Takayasu arteritis in a patient re-treated with interferon beta-1alpha for concomitant longstanding multiple sclerosis. Mod Rheumatol 2012; 22(3): 474-8.
  188. Chang CC, Lin CH, Su JJ. Severe necrosis and cellulitis complicating treatment with interferon beta-1a. Acta Neurol Taiwan 2020; 29(3): 90-4.
  189. Larochelle C, Grand'maison F, Bernier GP, Latour M, Cailhier JF, Prat A. Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome in relapsing-remitting multiple sclerosis patients on high-dose interferon beta. Mult Scler 2014; 20(13): 1783-7.
  190. Tavakoli M, Pour Manshadi SM, Naderi N, Dehghan A, Azizi S. Unusual side effects of interferon Beta-1a in patient with multiple sclerosis. Mater Sociomed 2012; 24(3): 203-5.
  191. Roskal-Walek J, Biskup M, Dolecka-Slusarczyk M, Rosolowska A, Jaroszynski A, Odrobina D. Manifestation of Susac syndrome during interferon beta-1a and glatiramer acetate treatment for misdiagnosed multiple sclerosis: a case report. BMC Ophthalmol 2021; 21(1): 352.
  192. Niessen A, Schwarz B, Urban M, Kramer S, Reinhard M. Aseptic meningitis after glatiramer acetate. J Neurol 2021; 268(7): 2589-90.