REBIF

Some information about my treatment of Rebif which starts tomorrow, Friday, August 26, 2005.

What is Rebif?

Rebif is the brand name for interferon beta-1a made by Serono. Interferons belong to a family of proteins which occur naturally in the body, helping to regulate the body's immune system and fight disease. There are three types of interferons, alpha, beta and gamma, and it is interferon beta that has been clinically proven to be effective against MS.

What are interferons?

They are naturally produced proteins that belong to a group of chemicals called the cytokines (a protein secreted by a cell to communicate with other cells. They play an important role in coordinating the immune system. Cytokines [literally, cell movers] signal the immune system to fight infection and to stop the immune response when infection has been eliminated.) Interferons can also help protect against viral infections by inhibiting viral growth and reproduction.

What does interferon beta do in MS?

Interferon beta is believed to affect changes in the immune system in three ways:

1. It affects the production of cytokines, increasing those that reduce inflammation and reducing those that produce inflammation. (In MS, an attack on the myelin sheath-a sheath made up of lipids [fats] and protiens whch surrounds the nerve cells-results in swelling.)

2. It helps control the function of T cells (a type of specialized immune cell which plays a central role in the immune system and are active in producing multiple sclerosis symptoms).

3. It helps control the movement of T cells into the central nervous system, where they can trigger changes that cause multiple sclerosis.

How is rebif made?

Rebif is manufactured by a special biotechnology process that uses mammalian cells (Chinese hamster ovary cells) to produce an interferon that has components similar to that of natural human interferons.

How does Rebif work?

The precise mechanism of action of interferons in MS is still under invertigation. It is thought that Rebif works by regulation the body's immune response against myelin (the body's natural electrical insulator: it speeds up the conduction of electrochemical messages between the central nervous system and the rest of the body). Basically, it stops the body from destroying its own myelin. Although Rebif is not a cure, it can alter the course of MS by delaying disability.

What to expect from treatments of Rebif:

Rebif has been shown to help reduce the number and severity of attacks, slow the progression of physical disability, reduce the number and volume of lesions or plaques (areas of injury or damage--in MS, an area of inflammation and demyelination in the brain or spinal cord) as seen on magnetic resonance imaging (MRI), reduce the requirement for steroids and reduce the number of hospitalizations for treatment of MS.

Because MS is different in each individual, you need to have a realistic idea of what to expect from treatment. It is difficult to predict how an individual will respond to the treatment. You may still have MS attacks, this does not mean that Rebif is not working. The number and severity of attacks, the progression of the disease, and the number of active lesions may all be reduced compared to what they might have been without Rebif treatment. This is why Rebif treatment should be continuous, even during a relapse of MS.

How is Rebif supplied and stored?

Rebif comes in prefilled syringes. They should be stored in the refrigerator (between 2 and 8 degrees C) in their original box and protected from light. They can be stored at room temp (up to 25 degrees C), but not for more than 1 month. DO NOT FREEZE.

What are the side effects of Rebif treatment?

Rebif is generally well-tolerated. The most common side effects seen in clinical trials were flu-like symptoms (fever, muscle aches, headache) and injection site reactions. Flu-like symptoms may last at least 3 months but tend to resolve with continued treatment. The use of acetaminophen or ibuprofen 30 minutes before injection may help reduce these symptoms.
Injection site reactions such as pain, redness, and swelling are common, but are manageable. Injecting at bedtime may be useful as you can sleep through the side effects.

Interferons can potentially disturb liver function. Symptoms of liver disorder include: loss of appetite accompanied by malaise, fatigue, nausea, vomiting, abdominal pain, dark urine, easy bruising of the skin, jaundice, or pruritis (itching).

*Information provided by MS clinic nurses: Josee Poirier, Colleen Harris, Jeannine Christopherson, Cathy Edgar, and Ruth Grigg.