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Interferon Beta-1B

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Interferon Beta-1B, Betaseron, Extavia

  • See Also
  1. Interferon Beta-1A
  2. Multiple Sclerosis
  • Indications
  1. Multiple Sclerosis - Relapsing Remitting
    1. Interferon has the longest use in MS than any of the other immunomodulators
  • Mechanism
  1. Interferon is an endogenous Cytokine (integral to inflammatory and immune responses)
    1. Released from Lymphocytes, Dendritic Cells, Macrophages, fibroblasts, Natural Killer Cells and T Cells
  2. Interferon is subdivided into three main types (alpha, beta, gamma)
    1. Alpha and beta Interferon both have Antiviral activity
    2. Synthesized alpha Interferon has primarily been used for Viral Hepatitis B and C infection, as well as cancer
    3. Synthesized beta Interferon has primarily been used to treat Multiple Sclerosis
  3. Interferon Beta is a type 1 Interferon, a Cytokine produced by fibroblasts
    1. Released in response to viral contact or DS-DNA
    2. Has Antiviral, antiproliferative and immunomodulator activity
  • Medications
  1. Interferon Beta-1B (Betaseron, Extavia): 0.3 mg single-dose vial (needs reconstitution)
  • Dosing
  1. Week 1-2: Give 0.0625 mg (0.25 ml) SQ every other day
  2. Week 3-4: Give 0.125 mg (0.5 ml) SQ every other day
  3. Week 5-6: Give 0.1875 mg (0.75 ml) SQ every other day
  4. Maintenance: 0.25 mg (1 ml) SC every other day
  5. Consider pretreat with Analgesics and Antihistamines to reduce flu-like reactions
  • Adverse Effects
  1. Allergic Reactions (including Anaphylaxis)
  2. Local injection site inflammation
  3. Influenza-like symptoms (decreases after first 3 months)
  4. Mental health adverse effects
    1. Exacerbation of depressed mood (including increased Suicidality)
    2. Psychosis
  5. Hematologic Effects
    1. Leukopenia
    2. Thrombotic Microangiopathy
  6. Hepatotoxicity
    1. Increased liver transaminases
    2. Risk of liver failure
    3. Avoid with other Hepatotoxins
    4. Monitor Liver Function Tests
  7. Pulmonary Arterial Hypertension
  8. Congestive Heart Failure
  9. Autoimmune disorders (including Drug-induced Lupus)
  10. Seizures
  • Safety
  1. Unknown safety in Lactation
  2. Unknown safety in pregnancy
    1. No observed adverse effects in pregnancy in studies
  3. Monitoring (obtain at 1, 3 and 6 months)
    1. Complete Blood Count and Platelets
    2. Liver Function Tests
  • Efficacy
  1. Decreases Multiple Sclerosis exacerbation frequency
  2. Decreased risk of Disability progression
  3. Decreased MS related CNS Lesions
  • Resources
  1. Betaseron (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=66311f74-0472-4fa3-848a-06002ca0def5
  • References
  1. Filippini (2003) Lancet 361:545-52