interferon beta-1a


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Related to interferon beta-1a: Interferon beta-1b, Rebif, Glatiramer acetate, Avonex

interferon

 [in″ter-fēr´on]
any of a family of glycoprotein biological response modifiers used as antineoplastic agents and immunoregulators; they inhibit cellular growth, alter the state of cellular differentiation, have effects on the cell cycle, interfere with oncogene expression, alter cell surface antigen expression, have effects on antibody production, and regulate cytotoxic effector cells.
interferon-α the major interferon produced by virus-induced leukocyte cultures; its primary producer cells are null cells, and its major activities are antiviral activity and activation of NK cells.
interferon alfa-2a a synthetic form of interferon-α produced by recombinant technology that acts as a biologic response modifier, used as an antineoplastic in the treatment of hairy cell leukemia and AIDS-related Kaposi's sarcoma; administered intramuscularly or subcutaneously.
interferon alfa-2b a synthetic form of interferon-α produced by recombinant technology that acts as a biologic response modifier, used in the treatment of veneral warts, hepatitis B, and chronic hepatitis C and as an antineoplastic in the treatment of hairy cell leukemia, malignant melanoma, non-Hodgkin's lymphomas, multiple myeloma, mycosis fungoides, and AIDS-related Kaposi's sarcoma; administered intramuscularly, subcutaneously, or intralesionally.
interferon alfacon-1 a synthetic interferon related to both α and β interferons, produced by recombinant DNA technology; used in the treatment of chronic hepatitis C virus infection, administered subcutaneously.
interferon alfa-n3 a highly purified mixture of natural human interferon proteins that acts as a biologic response modifier; used in the treatment of venereal warts, administered intralesionally.
interferon-β the major interferon produced by double-stranded RNA-induced fibroblast cultures; the major producer cells are fibroblasts, epithelial cells, and macrophages, and its major activity is antiviral.
interferon beta-1a a synthetic form of interferon-β produced by recombinant DNA techniques that acts as a biologic response modifier; used in the treatment of relapsing forms of multiple sclerosis; administered intramuscularly.
interferon beta-1b a synthetic modified form of interferon-β produced by recombinant DNA techniques; used as a biologic response modifier in the treatment of relapsing forms of multiple sclerosis; administered subcutaneously.
interferon-γ the major interferon produced by lymphocyte cultures that have been immunologically stimulated by mitogens or antigens; the major producer cells are T lymphocytes, and its major activity is immunoregulation.
interferon gamma-1b a synthetic form of interferon-γ produced by recombinant technology that acts as a biologic response modifier and antineoplastic. It is used to reduce the frequency and severity of serious infections associated with chronic granulomatous disease, administered subcutaneously.

interferon beta-1a

(in-ter-feer-on bay-ta won-aye) ,

Avonex

(trade name),

Rebif

(trade name)

Classification

Therapeutic: anti multiple sclerosis agents
Pharmacologic: interferons
Pregnancy Category: C

Indications

Relapsing forms of multiple sclerosis.

Action

Antiviral and immunoregulatory properties produced by interacting with specific receptor sites on cell surfaces may explain beneficial effects.
Produced by recombinant DNA technology.

Therapeutic effects

Reduce incidence of relapse (neurologic dysfunction) and slow physical disability.

Pharmacokinetics

Absorption: 50% absorbed following subcut administration.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: 69 hr (subcutaneous), 10 hr (IM).

Time/action profile (serum concentrations)

ROUTEONSETPEAKDURATION
IMunknown3–15 hrunknown
SCunknown16 hrunknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity to natural or recombinant interferon beta or human albumin.
Use Cautiously in: Patients with a history of suicide attempt or depression; History of seizures; Cardiovascular disease; Liver disease; History of alcohol abuse; Patients with childbearing potential; Obstetric / Lactation / Pediatric: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

  • seizures (life-threatening)
  • depression (most frequent)
  • dizziness (most frequent)
  • fatigue (most frequent)
  • headache (most frequent)
  • drowsiness
  • incoordination
  • rigors
  • suicidal ideation

Ear, Eye, Nose, Throat

  • sinusitis (most frequent)
  • vision abnormalities

Respiratory

  • upper respiratory tract infection

Cardiovascular

  • chest pain
  • heart failure

Gastrointestinal

  • abdominal pain (most frequent)
  • nausea (most frequent)
  • autoimmune hepatitis
  • dry mouth
  • elevated liver function studies

Genitourinary

  • urinary tract infection (most frequent)
  • urinary incontinence
  • polyuria

Dermatologic

  • alopecia
  • rash

Endocrinologic

  • hyperthyroidism
  • hypothyroidism
  • spontaneous abortion

Hematologic

  • neutropenia (most frequent)
  • anemia
  • thrombocytopenia

Local

  • injection-site reactions (most frequent)
  • injection site necrosis

Musculoskeletal

  • myalgia (most frequent)
  • arthralgia
  • back pain
  • muscle spasm

Miscellaneous

  • allergic reactions including anaphylaxis
  • chills (most frequent)
  • fever (most frequent)
  • flu-like symptoms (most frequent)
  • pain (most frequent)

Interactions

Drug-Drug interaction

↑ myelosuppression may occur with other myelosuppressives including antineoplastics.Concurrent use of hepatotoxic agents may ↑ the risk of hepatotoxicity (↑ liver enzymes). Avoid concommitant use with immmunomodulating natural products such as astragalus, echinacea, and melatonin.

Route/Dosage

Avonex
Intramuscular (Adults) 30 mcg once weekly.
Rebif
Subcutaneous (Adults) Target dose of 22 mcg 3 times/wk–Start with 4.4 mcg 3 times/wk for 2 wk, then increase to 11 mcg 3 times/wk for 2 wk, then increase to maintenance dose of 22 mcg 3 times/wk;Target dose of 44 mcg 3 times/wk–Start with 8.8 mcg 3 times/wk for 2 wk, then increase to 22 mcg 3 times/wk for 2 wk, then increase to maintenance dose of 44 mcg 3 times/wk.

Availability

Avonex
Powder for injection: 30 mcg/vial
Prefilled syringes: 30 mcg/0.5 mL
Prefilled pens: 30 mcg/0.5 mL
Rebif
Pre-filled syringes: 22 mcg/0.5 mL, 44 mcg/0.5 mL, titration pack of 6 syringes prefilled with 8.8 mcg/0.2 mL and 6 syringes prefilled with 22 mcg/0.5 mL

Nursing implications

Nursing assessment

  • Assess frequency of exacerbations of symptoms of multiple sclerosis periodically during therapy.
  • Monitor patient for signs of depression during therapy. If depression occurs, notify.health care professional immediately.
  • Lab Test Considerations: Monitor hemoglobin, WBC, platelets, and blood chemistries including liver function tests prior to and 1, 3, and 6 mo after initiation of therapy. Therapy may be temporarily discontinued if the absolute neutrophil count is < 750/mm3, if AST or ALT exceeds 10 times the upper limit of normal, or if serum bilirubin exceeds 5 times the upper limit of normal. Once the absolute neutrophil count is > 750/mm3 or the hepatic enzymes have returned to normal, therapy can be restarted at 50% of the original dose. Thyroid function tests should also be monitored every 6 mo, especially in those patients with a history of thyroid abnormalities.

Potential Nursing Diagnoses

Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

  • Do not confuse products. Interferon beta-1a and interferon beta-1b are not interchangeable.
  • Avonex:Reconstitute with 1.1 mL of diluent and swirl gently to dissolve. Do not shake the vial. Inject into the thigh or upper arm. Keep reconstituted solution in refrigerator; inject within 6 hr of reconstitution.
    • Rebif:Administer subcutaneously via pre-filled, single-use syringe at the same time (preferably the late afternoon or evening) on the same days (Monday, Wednesday, Friday) at least 48 hr apart each wk. Rotate sites with each injection to minimize risk of injection site reactions. Discard unused portions. Store in refrigerator.

Patient/Family Teaching

  • Home Care Issues: Instruct patient in correct technique for injection and care and disposal of equipment. Caution patient not to reuse needles or syringes and provide patient with a puncture-resistant container for disposal.
    • Instruct patient to take medication as directed; do not change dose or schedule without consulting health care professional. Patients should receive a medication guide with each product.
    • Inform patient that flu-like symptoms (fever, chills, myalgia, sweating, malaise) may occur during therapy. Acetaminophen may be used for relief of fever and myalgias.
    • Obstetric: Advise patient to notify health care professional if pregnancy is planned or suspected. May cause spontaneous abortion.

Evaluation/Desired Outcomes

  • Decrease in the frequency of relapse (neurologic dysfunction) in patients with relapsing-remitting multiple sclerosis.

interferon beta-1a

an antiviral and immune system regulator.
indications It is prescribed in the treatment of relapsing forms of multiple sclerosis. It can help reduce the number of neurological attacks and slow the progress toward physical disability.
contraindications It should not be given to patients with allergy or sensitivity to interferon beta-1a or components of its formulation.
adverse effects The side effects most often reported include headache, muscle aches, chills, fever, weakness, and influenza-like symptoms.
References in periodicals archive ?
The package insert included in the original Food and Drug Administration application for intramuscular interferon beta-1a (Avonex) stated that some patients in the treatment group reported decreased hearing sensitivity.
Every-other-day interferon beta-1b versus once-weekly interferon beta-1a for multiple sclerosis (INCOMIN Trial) II: analysis of MRI responses to treatment and correlation with Nab.
During the first year of treatment, those on monotherapy had 66% fewer relapses than those on placebo, and in the second trial, those on the combination had 54% fewer relapses than those on interferon beta-1a alone.
A 46-percent and 47-percent reduction in the ARR compared with interferon beta-1a over the two-year period in OPERA I and OPERA II, respectively (p
coli cells and interferon beta-1a is produced in mammalian cells.
In this randomized trial involving 840 patients, a 49 percent reduction in relapse rate was observed in patients treated with alemtuzumab 12 mg compared to interferon beta-1a over two years of study (p<0.
Another Phase III clinical trial, CARE-MS II, is currently underway, evaluating alemtuzumab against interferon beta-1a in relapsing-remitting MS patients who have relapsed while on therapy.
Early Effects of Interferon beta-1a SC tiw Versus Interferon beta-1a IM qw on MRI Outcomes in Patients with Relapsing MS in the EVIDENCE Study
Rebif, an interferon beta-1a product, was recently approved for use in the United States by the Food and Drug Administration (FDA) for treatment of relapsing forms of multiple sclerosis (MS).
Total quantity or scope: Task 1 - interferon beta-1a (vial amp.
The ONWARD (Oral Cladribine Added ON To Interferon beta-1a in Patients With Active Relapsing Disease) study: a Phase II placebo-controlled trial designed primarily to evaluate the safety and tolerability of adding Cladribine Tablets treatment to patients with relapsing forms of MS, who have experienced breakthrough disease while on established interferon-beta therapy.
This study describes the experience of patients on the most commonly prescribed disease-modifying medicine, interferon beta-1a (Avonex[R]).

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