Life with MS & EDS

January 5, 2009

Drug Evaluation #4 – Rebif

Rebif is the medication I knew the least about before watching their DVD. I’m glad I saved them for last. It was a well-done marketing tool. Their format was similar to the others, but it was concise and certainly not demeaning like the Copaxone one. There wasn’t a dedicated narrator. Instead they used doctors and nurses to explain things and included stories of people who use Rebif. Rather than having them direct responses to an interviewer, they just showed the people talking. That made a big difference in the video’s tone.

After already seeing 3 other marketing DVDs, I didn’t think there was much more to learn, but they proved me wrong. Their general info was the same as the others (what MS is, what it does to the body, symptoms some people get, basic vocabulary, etc.) But, every drug company has an angle and the makers of Rebif certainly played up the “slows disability progression” aspect. They all need to differentiate themselves and this is Rebif’s approach.

It’s obvious that Rebif considers Avonex to be their main competition and that they are targeting people who may want to switch from Avonex to something else. I really like the idea that it is an Interferon beta-1a, which occurs naturally in the body (just like Avonex). I finally looked up what the difference is between 1a and 1b (Betaseron):

Interferon beta-1a is produced by mammalian cells

Interferon beta-1b is produced in modified E. coli (there’s a turn off!)

Like the other drugs, it has an auto-inject contraption. They are down to a 29 gauge needle, just like Copaxone and only one number up from Betaseron. I’m not sure if any of the others do this or not, but when you start Rebif they have a Titration Pack, which starts at a lower dosage and increases to the full strength over about a month. (I thought that was interesting. It reminded me of my allergy shots.) The drug comes in pre-measured, pre-filled syringes and can be out of the fridge for up to 30 days (although they seem to recommend keeping it in the fridge and removing it 1 – 4 hours before injection time.) Like the other drugs, they have a support system with nurses and advisors. Rebif spent a little more time than the other specifically talking about financial assistance.

I honestly liked what I saw. Rebif is taken 3 times a week and you choose the days as long as they are 48 hours apart. So, you can pick Monday, Wednesday, and Friday and never do it on a weekend. It has a good track record and is proved to reduce MRI lesion area and activity, reduce relapses, and delay disability progression relative to placebo treatment. Their tests have shown that people have less flu-like symptoms compared with Avonex, but everyone does react differently to the various medications. The injection site reaction was more frequent than Avonex, probably because of the inter muscle shot vs. the under the skin shot.

But, they lost me at the side effects. Like the other interferons, Rebif can mess up your liver, thyroid, and white blood cells.

After the video I looked through the materials in their package. Something in there actually explained a problem I’ve been having. In their symptoms section they talk about Nystagmus. This is an uncontrolled horizontal or vertical eye movement. This has been happening for a while now in my right eye (the same one with the optic neuritis). I only notice it when I’m working on the computer. I’ll be looking at the screen and then notice my eyes quickly shift to the left and then go right back to where they were focused before. It’s nice to have a name for this annoyance.

Well, now that my reviews are done, it’s decision time! My neurology appointment is Wednesday morning, so I don’t have a lot of time left. I’m typically rather indecisive, but I think I’ve done enough research now to be able to make a decision. It’s a good thing I have a cut-off date or I’d just keep doing research and never pick one!

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