Administration of subcutaneous interferon Reducing flu like symptoms


This is not a post on Covid-19, but a post for the readers who use the beta interferons you may be interested in this. I makeno comment I’m not a neuro

Administration of subcutaneous interferon beta 1a in the evening: data from RELIEF study. Patti F, Zimatore GB, Brescia Morra V, Aguglia U, Bossio RB, Marziolo R, Valentino P, Chisari CG, Capacchione A, Zappia M; RELIEF Study Group.J Neurol. 2020 Mar 5. doi: 10.1007/s00415-020-09771-x. [Epub ahead of print

BACKGROUND:Subcutaneous recombinant interferon-beta 1a (IFN-β1a SC) is indicated for treatment of relapsing multiple sclerosis (RMS); however, it is associated with development of flu-like syndrome (FLS) in 75% of patients. No recommendations are available on whether evening or morning administration could induce better or worse FLS.

OBJECTIVE:Primary objective was to investigate whether morning administration of IFN-β1a 44 µg (Rebif) would affect the severity of FLS versus evening administration, in patients with RMS. Secondary objectives were to investigate whether timing of administration could lead to a better quality of life.

METHODS:Multicenter, open-label, 12-week, randomized, controlled, parallel-group, phase 4 study.

RESULTS:Of 217 patients screened at 29 Italian sites, 200 were included in the study. Among these, 104 patients were randomized to IFN-β1a SC administration in the morning and 96 in the evening. Morning administration resulted in higher FLS scores, as measured by the Multiple Sclerosis Treatment Concern Questionnaire, at week 4 (p = 0.0083) and week 8 (p = 0.0079); however, the difference was no longer significant at the end of 12 weeks.

CONCLUSION:IFN-β1a evening injections in the first 8 weeks of treatment led to an improvement in FLS; when continuing therapy, time of administration could be decided according to patient’s lifestyle and preference.

COI Multiple. None considered relevant

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  • This has been my preference advice to pwMS ever since I started prescribing Beta-Interferons in the late 1990s, so I’m pleased this advice is now evidence-based.

  • Paracetamol after injection lessened the fever and chills in my experience. Now I moved on to natalizumab. Good riddance to the INFs.

  • I’d have a solid two days of feeling awful after every injection even with NSAIDs; time of day was irrelevant. I am so glad these meds existed when they were most needed, but I am also glad that there are other, better ones available now.

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