Interferon decision

[nblaze]

I was recently diagnosed and have to make the decision which interferon to take. I would appreciate any information to help me make the best decision.

Thanks

[earnellzwifey]

From my understanding the crab's basically do the same thing. i guess the question you need to answer is how often and where do you want to have to take your injections.

I am unsure of which one is daily, but I know that rebif is 3 times a week. There is one that is weekly but you have to inject in the muscle which I hear is a little more painful.

I am currently not on one so I can't share my own experiences with DMD's. Hope you the best in your search.

[MelissaQ]

Hi there. I am currently on Rebif, which is a subcutaneous injection 3 times a week. There is also Betaseron which is a subcutaneous injection every other day. And Avonex which is a once a week injection but it is an intramuscular route.

I can only speak for Rebif since it's the only DMD I have taken so far. The injection is pretty painless for me, I don't use the autoinject so I can control how fast the med is injected. The needle is super small, I usually barely feel it as long as I make sure the alcohol is dry. I have to take Tylenol or ibuprofen at least by a couple hours after my injection, otherwise I feel chills and get headaches. But it's never been a side effect that has ever stopped me from doing anything. And if I take something, I don't notice the side effects at all.

Most people I think inject at night and then go to bed. But I have recently found, that I feel better if I inject while I'm going to be awake for several hours. Less headaches for some reason.

Good luck with your decision!!

[0485c10]

long, DMD choice: I hope its somewhat useful.

I wrote all this for a reply to someone choosing a ms Med and I copied and saved it on my PC...

i'll copy it here too-in case you find it helpful. Its an older post, written in April 2010---the estimated costs have changed

And a word of warning, it is slanted toward betaseron because that is the one I started with and was pleased with it.

Its mostly a process of divide by two...(I have a computer back ground, so I like dividing by 2 algorithms)

Copaxone part
1. Chose an Interferon or Copaxone is the single biggest difference in DMD drugs.

Copaxone worked in the CNS system by loading a bunch of decoy myelin cells for the immune system to attack instead of the real thing..

it takes about 6-9 months to reach its full effectiveness by building up a supply of the decoy myelin cells to hit instead of the real thing. It becomes partially effective immediately and increases in effectiveness for the next 6-9 months when it reaches its full effectiveness.

It has the lowest risk to a fetus if pregnancy accidentally happens. A pregnant a woman is advised to stop their DMD while pregnant and resume it immediately after or after breast feeding is done.

It is as shot done every day with a small subcutaneous needle. It has the least side affects. And I believe it is the least expensive?? Its tough looking those # up because they change-5 years ago it was the least expensive. (but expensive is relative, they are all expensive, copaxone was about $12,000 a month with the most expensive one at $26,000 a month. They all have Prescription assistance programs to help with the cost for uninsured and under insured)

Copaxone has to be refrigerated-but it can be taken out of the refrigerator up to a week in advance(? check details) because a person wants a shot a room temperature before doing it or the cold stings

Because it is done every day a common side affect after time is necrosis of the skin or "puckering" dimmples where shots have been done as the fat under the skin gets affected or lessens. that seems to happen more with people who don't have a lot of fat. It is also considered by many as the least effective, but how effective it will be in a person is unopredictable?

A person just has to try it to find out. Some people copaxone doesn't work well for them then an Interferon does, and for some people an interferon doesn't work well for them then copaxone does? No predicting it at this time. A person just has to try it and see. I believe copaxone may be the most popular on this message board?

Interferons work in the immune system by loading a bunch of extra cytokin cells, the cells the immune system uses to determine if their is a virus and attack it. With these extra cytokin cells the immune system is too busy attecking these "fake" alarm cells to mistakenly attack the mylen. Because the immune system thinks its always under attack they do have "flu like" symptoms,,,headache, sore muscles, chills,. After a while the body gets used top it and the "flu like symptoms stop for most. I don't know, I was a person who never got the flu like symptoms so that can happen also. Usually the a person takes some tylenol or something like that 20 minutes before the shot just before bed and sleeps through most of it...

Interferons have 3 possible meds..avonex,Betasron, rebif.

So the first divide by 2 is done: if Copaxane is chosen exit. If an interferon is desired continue.

INTERFERON PART

2. Divide by 2 again if an interferon is considered. There are two types of interferons: interferon-1b, interferon-1a. That's transparent to the user, but a way to divide by two.

Intereferon 1a is from the mamory gland while 1b is from a modified Ecoli.

Interferon 1b is betaseron. It is stored a room temperature, so its easier to travel with and takes up no space in the refrigerator, doesn't have to be taken out to 'warm up" before injecting it.

The shot does have to be assembled. It comes with a package to do it, the dilutant had to be injected into the powder--It is also a small subcutaneous needle. it was the first MS med available in 1993 and is thought to be the strongest. It is probably the second most expensive drug.(5 years ago)

Interferon 1a is both Rebif & Avonnex..

So if you want to go with an interferon 1b stop & select betaseron.
If not continue.
__________________________________________________ _
Interferon 1a---
Avonnex is also an interferon(Interferon 1 a) so it has the flu like symptoms. It is a long needle done directly into the muscle, but the exchange is it is only done once a week.

It has the least amount of skin reactions. If someone gets a skin reaction-necrosis or skin puckering with the sub cutaneous injections, they will often be switched to avonnex.

It has to be stored in the refrigerator-it arrives as a pre assembeled shot. Expense wise it is just above copaxone. I believe it is the most widely used DMD for MS.?

Every Rebif shot done three times a week is more interferon 1a than the single weekly shot of avonnnex.

They both have about the same effectiveness but Rebif is thought to be stronger from more frequent dosings.

Avonnex is thought need less for the same approx efficiency because it is inter muscular (long needle)and not subcutaneous?

People are often switched from Avonnex to Rebif, when they need something stronger---but not many(I haven't read of it in 6 years) are switched from Rebif to Avonnex??

Rebif is a a subcutaneous injection that is done Mon,Wed, & Friday. It arrives pre-assembled,has to be stored in the refrigerator. But is taken our early to come to room temperature before the shot.

It is the most expensive DMD because it recently changed its formula to make it a PH compatible with the body. If the med is cold, it stings when the shot is done and if it is not the same PH it stings.

So they changed the formulation last year to make it PH compatible---the new PH compatible formulation is available outside the US but it may still be waiting FDA approval in the US? ???

When Betaseron became less effective for me I switched meds. I considered Rebif, I called shared solution to ask if the new formulation was available in the US. At that time, 2 years ago it was still in the FDA. I'm not certain if it is out.?

If you go to Rebif call and ask them if the non sting formula it is out in the US yet?

Rebif has not done any testing trial to show it slows disability- but it has been proven to slow relapse lesion development as all the MS meds. People often are switched from Avonnex to the stronger Rebif.

Thats the last of the divide my 2: select either Rebif or Avonnex if you have gone this far.

DMD in Genreral

The strength of the MS meds appear to be from strongest to weakest: betaseron, Rebif,Avonnex and Copaxone. IMO and many docs. Copaxone expense wise: (most expensive to least about $26,000/mo to about $12,000/mo) Rebif, Betaseron, Avonnex, Copaxone.


But these expense # change, get the current # the gov I go to my Part D budget planner to get an idea of what they are paying for it. I am on Silver Script Part D. And check the details of the cost in the gap, because that is the actual cost of the med. On the left is Quick links and that will get you the ability to select the state and med.

http://www.silverscript.com/en-US/new_default.aspx

cont....Betaseron & Rebif

I'm gonna write this down so I get all of it....when I write it.

There really is not that much difference between rebif & betaseron. Two things I forget to add: rebif is harder on the liver than betaseron. And interferons in general are harder on the liver that copaxone. With an intereferon a blood test is given each year for liver enzymes. If they go too much out of range them the person has to switch to a different one. Rebif is the hardest on the liver, then betaseron, then avonnex and copaxone not at all not at all.

The biggest reason for a DMD to not work is noncompliance and with its MWF schedule, Rebif is easier to remember and betaseron with its every other day not tied to a calendar or weekly schedule is easier to forget and be "accidentally" non compliant,.

After a while its tough to remember did I do my shot yesterday or the day before? Probably a person has to keep it written on the calendar, I had difficulty with that when I did I use it.

Rebif has a very aggressive financial support program....

http://www.needymeds.org/drug_list.t...me&name=Avonex

http://www.needymeds.org/drug_list.t...ame&name=Rebif


To get drug menu:

http://www.needymeds.org/drug_list.t...=list&letter=A

Summary---IMO---with all the stronger new oral meds coming out soon, its best to start with one one of the stronger current ms meds so your next switch is to the next generation stronger med: Rebif or Betaseron. I started with betaseron and was very pleased with it.