II. Indications
-
Multiple Sclerosis - Relapsing Forms
- Interferon has the longest use in MS than any of the other immunomodulators
III. Mechanism
-
Interferon is an endogenous Cytokine (integral to inflammatory and immune responses)
- Released from Lymphocytes, Dendritic Cells, Macrophages, fibroblasts, Natural Killer Cells and T Cells
-
Interferon is subdivided into three main types (alpha, beta, gamma)
- Alpha and beta Interferon both have Antiviral activity
- Synthesized alpha Interferon has primarily been used for Viral Hepatitis B and C infection, as well as cancer
- Synthesized beta Interferon has primarily been used to treat Multiple Sclerosis
- Interferon Beta is a type 1 Interferon, a Cytokine produced by fibroblasts
- Released in response to viral contact or DS-DNA
- Has Antiviral, antiproliferative and immunomodulator activity
IV. Medications
- Interferon Beta-1A
- Avonex 30 mcg vials or prefilled syringes
- Rebif Titration Kits, and 22 and 44 mcg prefilled syringes and autoinjectors
- Peginterferon Beta-1A
- Plegridy Starter Pack and 125 mcg pens and prefilled syringes
V. Dosing
- Avonex
- Target Dose: 30 mcg IM once weekly
- Start: 7.5 mcg IM weekly and increase dose by 7.5 mcg each week until at 30 mcg dose
- Titration allows for lower risk of flu-like symptoms
- Rebif
- Choose between 2 target doses
- Target 22 mcg SC three times weekly (same days each week, each dose 48 hours apart)
- Start 4.4 mcg SQ three times weekly for 2 weeks
- Next 11 mcg SQ three times weekly for 2 weeks,
- Next 22 mcg SQ three times weekly
- Target 44 mcg SC three times weekly (same days each week, each dose 48 hours apart)
- Start 8.8 mcg SQ three times weekly for 2 weeks
- Next 22 mcg SQ three times weekly for 2 weeks,
- Next 44 mcg SQ three times weekly
- Plegridy (Peginterferon Beta-1A)
- Day1: Start 63 mcg SQ
- Day 15: Increase to 94 mcg SQ
- Day 29: Increase to 125 mcg SQ
- Next: Continue 125 mcg SQ every 14 days
- Pretreat with Analgesics and Antihistamines to reduce flu-like reactions
- Increased drug levels and adverse reactions with renal Impairment
VI. Adverse Effects
- Allergic Reactions (including Anaphylaxis)
- Local injection site inflammation
- Influenza-like symptoms (decreases after first 3 months)
- Mental health adverse effects
- Exacerbation of depressed mood (including increased Suicidality)
- Psychosis
- Hematologic Effects
- Hepatotoxicity
- Increased liver transaminases
- Risk of liver failure
- Avoid with other Hepatotoxins
- Monitor Liver Function Tests
- Pulmonary Arterial Hypertension
- Congestive Heart Failure
- Autoimmune disorders
- Seizures
VII. Safety
- Pregnancy Category C
- Unknown Safety in Lactation
VIII. Efficacy
- Decreases Multiple Sclerosis exacerbation frequency
- Decreased risk of Disability progression
- Decreased MS related CNS Lesions
IX. Resources
- Avonex (DailyMed)
- Rebif (DailyMed)
- Plegridy (DailyMed)
Images: Related links to external sites (from Bing)
Related Studies
avonex (on 7/11/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
AVONEX PEN 30 MCG/0.5 ML KIT | $7,309.73 each | |
AVONEX PREFILLED SYR 30 MCG KIT | $7,341.09 each |
Ontology: Interferon-beta (C0015980)
Definition (NCI) | A class of interferon elaborated by fibroblasts. |
Definition (MSH) | One of the type I interferons produced by fibroblasts in response to stimulation by live or inactivated virus or by double-stranded RNA. It is a cytokine with antiviral, antiproliferative, and immunomodulating activity. |
Definition (CSP) | major interferon produced by double stranded RNA induced fibroblast cultures; the primary producer cells are fibroblasts, epithelial cells and macrophages, and the major activity is antiviral. |
Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129) |
MSH | D016899 |
SnomedCT | 420710006, 136112008, 84905003 |
LNC | LP18172-4, MTHU003525 |
English | beta Interferon, beta-Interferon, Interferon, beta, Interferon, Fibroblast, Interferon beta (substance), fibroblast interferon, Interferon-beta [Chemical/Ingredient], beta-interferon, interferon-beta, beta interferons, beta interferon, IFNb, interferon beta natural, interferon beta, Interferon.beta, Interferon beta, Beta interferon, Interferon beta (product), Beta interferon (substance), IFN-B, Fibroblast Interferon, Endogenous Interferon Beta, IFN-Beta, Interferon Beta, Natural, Interferon Beta, Interferon, Beta, Natural human interferon beta, Beta Interferon, Beta-Interferon, Interferon-beta |
Spanish | interferón beta (sustancia), beta interferón (sustancia), beta interferón, interferón beta (producto), interferón beta, Interferón Fibroblastico, Interferón beta |
Swedish | beta-interferon |
Czech | interferon beta, interferon fibroblastový |
Finnish | Beetainterferoni |
French | IFN-bêta, Interféron fibroblastique, Interféron bêta |
Russian | BETA-INTERFERON, INTERFERON BETA, INTERFERON-BETA, INTERFERON FIBROBLASTOV, БЕТА-ИНТЕРФЕРОН, ИНТЕРФЕРОН БЕТА, ИНТЕРФЕРОН-БЕТА, ИНТЕРФЕРОН ФИБРОБЛАСТОВ |
Japanese | インターフェロン-ベータ, ベータインターフェロン, インターフェロン-線維芽細胞, 線維芽細胞インターフェロン, インターフェロンβ |
Italian | Interferone fibroblastico, Beta-interferone, Interferone beta |
Polish | Interferon beta, Interferon fibroblastów |
Croatian | INTERFERON-BETA, INTERFERON BETA |
German | Beta-Interferon, Interferon, Fibroblasten-, Interferon-Beta |
Portuguese | Interferon beta, Interferon de Fibroblastos |
Ontology: Interferon beta-1a (C0254119)
Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129) |
MSH | C086937 |
SnomedCT | 386902004, 108749003 |
English | interferon beta 1a, interferon beta-1a, INTERFERON BETA-1A, 1a beta interferon, Interferon beta-1a (substance), Interferon beta-1a preparation (product), Interferon beta-1a preparation, Interferon beta-1a preparation (substance), Interferon beta-1a, Interferon Beta-1a |
Spanish | preparado de interferón beta - 1a, preparado de interferón beta-1a (producto), interferón beta-1a, interferón beta-1a (producto), preparado de interferón beta-1a, interferón beta - 1a (sustancia), interferón beta - 1a, preparado de interferón beta - 1a (sustancia), preparado de interferón beta-1a (sustancia) |
Ontology: Avonex (C0594372)
Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129) |
MSH | C086937 |
English | Avonex, avonex, Biogen brand of Interferon beta 1a |
Ontology: Rebif (C0752980)
Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
MSH | C086937 |
English | Rebif, rebif, Serono brand of interferon beta 1a |
Ontology: peginterferon beta-1a (C3848580)
Concepts | Pharmacologic Substance (T121) |
English | peginterferon beta-1a, PEGINTERFERON BETA-1A |
Ontology: Plegridy (C3848664)
Concepts | Pharmacologic Substance (T121) |
English | Plegridy |