Talk:Interferon beta-1a

NPOV dispute

These drugs have some awful side-effects which make them undesirable to many relapsing-remitting MS sufferers who can otherwise tolerate their symptoms. For patient reports you might look here [1] and here [2]. Whig (talk · contribs)

While these drugs do have side effects, these effects diminsh in time. The alternative is to not use them, allow the disease to progress and possibly leave you a crippled. While not perfect, these medications are the best and only line of defense against a horrible illness. As someone that is currently on Avonex, I can say that after three years of therapy, the worst part of the treatment is the needle! The side effects have become a non-issue. A slight headache is all that I experience and this can be eliminated by simply taking Advil, Tylenol or Alieve prior to taking the injection.

Natalizumab is by far the most effective med. on the market for RR MS. But most neurologists consider it substantially more dangerous so it isn't prescribed nearly as often. Interferon is considered closer to over-the-counter medicine regarding its safty. —Preceding unsigned comment added by 18.87.1.114 (talk) 07:53, 8 April 2008 (UTC)

Interferon is hardly comparable to OTC drugs with respect to adverse events; flu-like myalgias, fatigue and general malaise which may actually worsen after 2 weeks use, injection site reactions skin necrosis, lipoatrophy and an association with psychiatric sx, e.g. depression.

You make a good point about the pre-treatment prophylaxis with acetaminophen/antihistamine.

Natalizumab is actually much more tolerable; assuming no contraindications of allergies to it or any of its components or a history of PML it fares well. If you go past the first 7 days without signs of hepatotoxicity it can be expected to be tolerated quite well. —Preceding unsigned comment added by 134.153.184.17 (talk) 16:15, 12 April 2008 (UTC)

Inappropriate use of the NPOV tag. Just insert the info yourself! JFW | T@lk 06:55, 16 Jun 2005 (UTC)

There's no comparison between interferon and Natalizumab. The flu-like symptoms of interferon are medially benign. Natalizumab was a factor in about 10, possiblly more (I haven't kept track), deaths. It is even fair to say that Natalizumab was the cause of those deaths, since people don't get pml unless they are immune compromised. —Preceding unsigned comment added by 131.112.244.164 (talk) 11:43, 21 December 2009 (UTC)

Merge with IFNB1?

The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section. A summary of the conclusions reached follows.

Time to close discussion: no consensus for merge. -- P 1 9 9  ✉ 16:27, 30 October 2014 (UTC)

---

This drug is identical with human IFNB1 (Drugbank), and thus this article should be merged with the canonical page for the gene. Cory.b.giles (talk) 19:00, 20 September 2011 (UTC)

That looks like it should be fine. Just remember to follow CC-BY-SA when moving material (click on the link between the editing window and the edit summary box); Wikipedia:Copying within Wikipedia says that describing the source in your edit summary when moving the material suffices for licensing purposes. The new article will not be over long, and it will reduce some redundancy. Should we merge 1b as a subsection as well? FiveColourMap (talk) 01:18, 16 October 2011 (UTC)

Is gene identical with its product (proteine)? I'm in doubt. Akim Dubrow (talk) 13:02, 12 July 2012 (UTC)

Hello. IFNB1 is the correct HUGO-defined gene symbol for this gene in humans and clearly should be the central link for IFN beta for Wilkipedia. The Beta 1a and 1b variants refer to different way we humans generate recombinant proteins for IFNB1 (either in bacteria or in mammalian cells) for pharmaceutical application, but it is the same gene in both cases. the IFNB-1 and IFNB-2 definitions still need to be retained for those seeking information about different IFNB1 drugs available for human use but should clearly be considered as sub-nodes that sit below IFNB1. Thanks. (Lcharari (talk) 12:43, 19 March 2014 (UTC))

I am against merging:

• IFNB1 is about the protein produced in humans.
• Interferon beta 1a (tradenames: Avonex and Rebif) and Interferon beta 1b (tradenames: Betaseron/Betaferon) are used as drugs.

--LamasUI (talk) 05:39, 1 October 2014 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Move discussion in progress

There is a move discussion in progress on Talk:Interferon, alpha 1 which affects this page. Please participate on that page and not in this talk page section. Thank you. —RMCD bot 07:59, 15 May 2013 (UTC)

This article's name was Interferon beta-1a. Despite objections it was moved to Interferon beta 1a in June 2013. - Rod57 (talk) 08:39, 6 January 2016 (UTC)

Cost per week/month

The article now says USD4704 per week but according to all web sources it should be USD4704 per month. Only few Americans could afford that if paid weekly.

A one week dose of Avonex can cost up to $4,704 USD (retail cost of one prefilled 30 mcg syringe. There are four syringes in one kit.

Jankratochvil (talk) 06:44, 18 October 2014 (UTC)

Can we move brand names into its own section

Currently it's a subsection of Society and culture which prevents the brand names showing up in the contents summary box. - Rod57 (talk) 08:27, 6 January 2016 (UTC)

I am not sure what you mean by "summary box". The brand names are currently listed in the lead, the drug infobox, and in the brand name section. The current organization is also consistent with WP:PHARMOS. Boghog (talk) 09:10, 6 January 2016 (UTC)

'Society and culture' has been changed to 'Pharmaceutical analogs'. Mangofast (talk) 11:48, 24 February 2016 (UTC)

Factual Corrections

My name is Florian Schaub at Merck KGaA. My aim is to make some changes in this article, because we have identified some misleading information. I have provided clearly arranged suggestions that you can see below on the talk page. They all follow the same pattern:
• Current Version
• Suggested Revision (Suggested changes are bold)
• Reason
• Suggested Reference (if needed)
Please let me know if anyone has concerns.

_Current Version: “Trade names: Avonex, Rebif, CinnoVex”
Suggested Revision: “Trade names: Avonex, Rebif, Plegridy, as well as biosimilars”
Reason: Plegridy is now approved.

_Current Version: “It is produced by mammalian cells, while interferon beta 1b is produced in modified E. coli.”
Suggested Revision: Suggest supporting this statement with the reference Giovannoni JNNP 2002.
Reason:The statement is not currently referenced.
Suggested Reference: Giovannoni G et al. J Neurol Neurosurg Psychiatry 2002;73:465–469.

_Current Version: “Interferon beta has not been shown to slow the advance of disability.”
Suggested Revision: The effect of interferon beta-1a on disability progression differs depending on the trial. Some trials have shown that it does not have an effect on disability; however, many have shown that it does.
Reason: Text suggested to incorporate recent articles showing the effect of interferon beta-1a on disability progression.
Suggested References: Kappos L et al. JNNP 2015;0:1–6., Calabresi P et al. Lancet Neurol 2014;13:657-65., Jacobs LD et al. Ann Neurol. 1996;39:285-294.

_Current Version: “During a CIS, there is a subacute attack suggestive of demyelination but the patient does not fulfill the criteria for diagnosis of multiple sclerosis.”
Suggested Revision: “During a CIS there is a subacute attack suggestive of demyelination, which should be included in the spectrum of MS phenotypes.”
Reason: We have suggested updating the reference to reflect recent guidelines.
Suggested Reference: Lublin F et al. Neurology 2014;83:1–9.

_Current Version: “Also over time, a visible dent at the injection site due to the local destruction of fat tissue, known as lipoatrophy, may develop.”
Suggested Revision: “Also over time, a visible dent at the injection site due to the local destruction of fat tissue, known as lipoatrophy, may develop, however this rarely occurs with interferon treatment.”
Reason: The text is not referenced and not mentioned in either the US or EU product labels.
Suggested Reference: Edgar et al. Can J Neurol Sci 2004;31:58–63.

_Current Version: “The injection-site reactions can be mitigated by rotating injection sites or by using one of the medications that requires less frequent injections.”
Suggested Revision: “To help prevent injection-site reactions, patients are advised to rotate injection sites and use an aseptic injection technique. Injection devices are available to optimize the injection process.”
Reason: Text amended to match US and EU product labels. The suggestion of changing treatment to one requiring fewer injections was removed as injection site reactions are common in the interferon with the lowest frequency of injection (Plegridy).
Suggested Reference: US and EU product labels for Rebif and Avonex

_Current Version: “It was approved in Europe in 1998 and in the US in 2002 and is registered in more than 80 countries worldwide.”
Suggested Revision: “It was approved in Europe in 1998 and in the US in 2002; it has since been approved in more than 90 countries worldwide including Canada and Australia. EMD Serono has had sole rights to Rebif in the US since January 2016.”
Reason: Text updated in line with the Merck website.
Suggested Reference:
http://biopharma.merckgroup.com/en/products/neurodegenerative_diseases/multiple_sclerosis/rebif/rebif.html

http://www.merckgroup.com/en/media/extNewsDetail.html?newsId=9EA4062DCF310066C125798F0047EA32&newsType=1

http://www.prnewswire.com/news-releases/emd-serono-takes-on-exclusive-promotion-of-rebif-interferon-beta-1a-in-the-us-300205988.html

_Current Version: “Closely related is Interferon beta 1b, also may be indicated for multiple sclerosis, and with a very similar drug profile.”
Suggested Revision: “Closely related is interferon beta-1b, which is also indicated for MS, but is formulated with a different dose and administered with a different frequency. Each drug has a different safety/efficacy profile.”
Reason: Interferon beta 1b is now indicated for multiple sclerosis.
Suggested Reference: Nikfar S et al. Clinical Therapeutics 2010;32:1871–1888

_Current Version: “Retrieved from… Pfizer”
Suggested Revision: Suggest removing the link to the ‘Pfizer’ page.
Reason: Pfizer is no longer involved in the marketing of interferon beta-1a.

--Florian Schaub at Merck KGaA (talk) 16:00, 08 July 2016 (UTC)

Since nobody has any concerns regarding my request from 08 July 2016, I will start editing now.

--Florian Schaub at Merck KGaA (talk) 12:32, 19 July 2016 (UTC)

Rebif is anti-viral and no brain atrophy

Merck would possibly agree to add this feature as it has its own advantages not often mentioned. These key aspects are very important for patients and neurologists when deciding on which therapy to go on. — Preceding unsigned comment added by Don Rosenberger (talk • contribs) 22:34, 18 August 2016 (UTC)

Announcement of Changes

My name is Florian Schaub from Merck KGaA. My aim is to make some changes in this article because we have found some misleading information. I've compiled the suggested changes which you can find herinafter. They all follow one pattern:

• Current text

• Suggested revision

• Reason

• Suggested reference

If someone has objections please let me know.

_Current text

“Interferon beta-1a (also interferon beta 1-alpha) is a cytokine in the interferon family used to treat multiple sclerosis (MS).”

_Suggested revision

“Interferon beta-1a (also interferon beta 1-alpha) is a cytokine in the interferon family used to treat multiple sclerosis (MS). Three different drugs containing interferon beta-1a have been developed and are marketed in most English-speaking countries under the trade names Rebif1,2, Avonex3,4 and Plegridy5,6. The drugs differ in dose, frequency and method of injection (subcutaneous or intramuscular).”

_Reason

This text has been suggested to educate readers at the start of the article about the three available drugs, and to highlight their differences.

_Suggested reference

1. Rebif® US prescribing information. http://emdserono.com/ms.country.us/en/images/Rebif_PI_tcm115_140051.pdf. Accessed 16 October 2017

2. Rebif® Summary of product characteristics. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000136/WC500048681.pdf. Accessed 16 October 2017.

3. Avonex® US prescribing information. https://www.avonex.com/content/dam/commercial/multiple-sclerosis/avonex/pat/en_us/pdf/Avonex US Prescribing Information.pdf. Accessed 16 October 2017

4. Avonex® Summary of product characteristics. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000102/WC500029425.pdf. Accessed 16 October 2017

5. Plegridy® US prescribing information. https://www.plegridy.com/content/dam/commercial/multiple-sclerosis/plegridy/pat/en_us/pdf/november/plegridy-prescribing-information.pdf. Accessed 16 October 2017

6. Plegridy® Summary of product characteristics. https://www.medicines.org.uk/emc/medicine/29370. Accessed 16 October 2017

_Current text

“It is produced by mammalian cells, while interferon beta 1b is produced in modified E. coli.”

_Suggested revision

“It is produced by mammalian cells (Chinese hamster ovary cells), while interferon beta-1b (trade names: Betaferon1, Betaseron2 and Extavia5,6) is produced in modified E. coli bacteria.”

_Reason

Trade names added to provide the reader with additional information.

_Suggested reference

1. Betaferon® Summary of product characteristics. https://www.medicines.org.uk/emc/medicine/1809. Accessed 16 October 2017

2. Betaseron® US prescribing information. http://labeling.bayerhealthcare.com/html/products/pi/Betaseron_PI.pdf. Accessed 16 October 2017

3. Extavia® US prescribing information. https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/extavia.pdf. Accessed 16 October 2017

4. Extavia® Summary of product characteristics. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000933/WC500034701.pdf. Accessed 16 October 2017

_Current text

“Some claims have been made that interferons produce about an 18–38% reduction in the rate of MS relapses.”

_Suggested revision

“Interferons have been shown to reduce both the annual rate and severity of relapses in placebo-controlled clinical studies.”

_Reason

The claim is currently referenced to the website About.com; we suggest replacing this with Rebif and Avonex journal articles.

_Suggested reference

Jacobs LD, Cookfair DL, Rudick RA, Herndon RM, Richert JR, Salazar AM, Fischer JS, Goodkin DE, Granger CV, Simon JH, Alam JJ, Bartoszak DM, Bourdette DN, Braiman J, Brownscheidle CM, Coats ME, Cohan SL, Dougherty DS, Kinkel RP, Mass MK, Munschauer FE, Priore RL, Pullicino PM, Scherokman BJ, Whitham RH (March 1996). "Intramuscular interferon beta-1a for disease progression in relapsing multiple sclerosis. The Multiple Sclerosis Collaborative Research Group (MSCRG)". Annals of Neurology. 39 (3): 285–94. PMID 8602746. doi:10.1002/ana.410390304

Schwid S, Panitch H. (September 2007). "Full results of the Evidence of Interferon Dose-Response-European North American Comparative Efficacy (EVIDENCE) study: a multicenter, randomized, assessor-blinded comparison of low-dose weekly versus high-dose, high-frequency interferon beta-1a for relapsing multiple sclerosis". Clinical Therapeutics. 29 (3): 2031–2048. PMID 18035202. doi: https://doi.org/10.1016/j.clinthera.2007.09.025 PRISMS (Prevention of Relapses and Disability by Interferon beta-1a Subcutaneously in Multiple Sclerosis) Study Group (November 1998). "Randomised double-blind placebo-controlled study of interferon beta-1a in relapsing/remitting multiple sclerosis". The Lancet. 352 (9139): 1498–1504. PMID 9820297. https://doi.org/10.1016/S0140-6736(98)03334-0

Calabresi PA, Kieseier BC, Arnold DL, Balcer LJ, Boyko, A, Pelletier, J, Liu S, Zhu Y, Seddighzadeh A, Hung S, Deykin A (July 2014). "Pegylated interferon beta-1a for relapsing-remitting multiple sclerosis (ADVANCE): a randomised, phase 3, double-blind study". The Lancet Neurology. 13 (7): 657–665. doi:10.1016/S1474-4422(14)70068-7

_Current text

“Interferon beta has not been shown to slow the advance of disability.”

_Suggested revision

“The effect of interferon beta-1a on disability progression differs depending on the trial. Some trials have shown that it does not have an effect on disability1; however, many have shown that it does.2-4”

_Reason

Text suggested to incorporate recent articles showing the effect of interferon beta-1a on disability progression.

_Suggested reference

1. Jacobs LD, et al. Ann Neurol 1996;39:285–94.

2. PRISMS Study Group. Lancet 1998;352:1498–504

3.PRISMS Study Group. MS. Neurology 2001

4. Kappos L et al. J Neurol Neurosurg Psychiatry 2015;86:1202–7 5. Calabresi PA, et al. Lancet Neurol 2014;13:657–65

_Current text

“Medications are modestly effective at decreasing the number of attacks in relapsing-remitting multiple sclerosis…”

_Suggested revision

“Medications are effective at decreasing the number of attacks in relapsing-remitting multiple sclerosis…”

_Reason

Addition of new article (see right) to show that interferon beta-1a has a statistically significant effect on reducing the ARR.

_Suggested reference

De Stefano N, Sormani MP, Stubinski B, Blevins G, Drulovic JS, Issard D, Shotekov P, Gasperini C (January 2012). "Efficacy and safety of subcutaneous interferon β-1a in relapsing-remitting multiple sclerosis: further outcomes from the IMPROVE study". Journal of the Neurological Sciences. 312 (1-2): 97–101. PMID 21880336. doi: 10.1016/j.jns.2011.08.013

_Current text

“Interferons reduce relapses by approximately 30% and their safe profile makes them first-line treatments”

_Suggested revision

“Treatments based on interferon beta-1a reduce relapses by 18–58% after 4 months of treatment and their favourable safety profile makes them first-line treatments”

_Reason

Compliance with industry guidelines on use of the word ‘safe’. The relapse rate has also been updated to reflect Rebif and Avonex journal articles.

_Suggested reference

De Stefano N, Sormani MP, Stubinski B, Blevins G, Drulovic JS, Issard D, Shotekov P, Gasperini C (January 2012). "Efficacy and safety of subcutaneous interferon β-1a in relapsing-remitting multiple sclerosis: further outcomes from the IMPROVE study". Journal of the Neurological Sciences. 312 (1-2): 97–101. PMID 21880336. doi: 10.1016/j.jns.2011.08.013

Jacobs LD, Cookfair DL, Rudick RA, Herndon RM, Richert JR, Salazar AM, Fischer JS, Goodkin DE, Granger CV, Simon JH, Alam JJ, Bartoszak DM, Bourdette DN, Braiman J, Brownscheidle CM, Coats ME, Cohan SL, Dougherty DS, Kinkel RP, Mass MK, Munschauer FE, Priore RL, Pullicino PM, Scherokman BJ, Whitham RH (March 1996). "Intramuscular interferon beta-1a for disease progression in relapsing multiple sclerosis. The Multiple Sclerosis Collaborative Research Group (MSCRG)". Annals of Neurology. 39 (3): 285–94. PMID 8602746. doi:10.1002/ana.410390304

_Current text

“It is known that 30% of MS patients are non-responsive to Beta interferon.”

_Suggested revision

“Reports of patients with MS who are non-responsive to interferon beta vary depending on the criteria determining non-response. As with many drugs, individual results depend on the patient.”

“It is important to assess the patient’s adherence to therapy.”

_Reason

The original claim was not supported by the reference.

Suggest to also emphasize the importance of treatment adherence with the addition of this new text.

_Suggested reference

Sormani MP and De Stefano N (September 2013). "Defining and scoring response to IFN-β in multiple sclerosis". Nature Reviews Neurology. 9 (9): 504–512. PMID 23897407. doi: 10.1038/nrneurol.2013.146

_Current text

“While more studies of the long-term effects of the drugs are needed, existing data on the effects of interferons indicate that early-initiated long-term therapy is safe and it is related to better outcomes.”

_Suggested revision

“Interferon beta-1a was one of the earliest approved therapies for MS, and has over 20 years of patient experience in trials and in the clinic. Existing data on the effect of interferons indicate that early-initiated long-term therapy is well tolerated and related to favourable outcomes.

_Reason

The current references were published in 2008 and 2010. We propose also including the recent 15-year follow-up study, which provides long-term data for Rebif.

‘Better outcomes’ changed to ‘favourable outcomes’ to remove the hanging comparator.

Compliance with industry guidelines on use of the word ‘safe’.

_Suggested reference

Kappos L, Kuhle J, Multanen J, Kremenchutzky M, Verdun di Cantogno E, Cornelisse P, Lehr L, Casset-Semanaz F, Issard D, Uitdehaag BM (November 2015). "Factors influencing long-term outcomes in relapsing-remitting multiple sclerosis: PRISMS-15". Journal of Neurology, Neurosurgery, and Psychiatry. 86 (11): 1202–7. PMC 4680156. PMID 26374702. doi:10.1136/jnnp-2014-310024

_Current text

“While more studies of the long-term effects of the drugs are needed, existing data on the effects of interferons indicate that early-initiated long-term therapy is safe and it is related to better outcomes.”

_Suggested revision

Adherence to treatment is known to improve patient outcomes and reduce the risk of relapse. It is, therefore, important to continue therapy during perceived disease-free periods.”

_Reason

Information on adherence included to complement existing information.

_Suggested reference

Steinberg SC, Faris RJ, Chang CF, Chan A, Tankersley MA (February 2010). "Impact of adherence to interferons in the treatment of multiple sclerosis: a non-experimental, retrospective, cohort study". Clinical Drug Investigation 2010; 30 (2): 89–100. PMID 20067327. doi: 10.2165/11533330-000000000-00000

_Current text

“Interferon beta 1a is available only in injectable forms, and can cause skin reactions at the injection site that may include cutaneous necrosis.”

_Suggested revision

“Interferon beta-1a is available only in injectable forms, and can cause skin reactions at the injection site that may include cutaneous necrosis (occurring in ≤3% of patients). Good injection technique is recommended to reduce the frequency of injection site reactions.”

_Reason

Cutaneous necrosis occurs in ≤3% of patients – we suggest including the rates of patients developing necrosis to show that this is an uncommon occurrence.

_Suggested reference

Rebif EU Summary of Product Characteristics (July 2017). http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000136/WC500048681.pdf. Retrieved 26 July 2017

Rebif US Prescribing Information (November 2015). http://www.emdserono.com/ms.country.us/en/images/Rebif_PI_tcm115_140051.pdf. Retrieved 26 July 2017

Avonex EU Summary of Product Characteristics (July 2017) http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000102/WC500029425.pdf. Retrieved 26 July 2017

Avonex US Prescribing Information (March 2016). https://www.avonex.com/content/dam/commercial/multiple-sclerosis/avonex/pat/en_us/pdf/Avonex_Prescribing_Information.pdf. Retrieved on 26 July 2017

Walther EU, Hohlfeld R (November 1999). "Multiple sclerosis: side effects of interferon beta therapy and their management". Neurology. 53 (8): 1622–1627. PMID 10563602. doi:10.1212/wnl.53.8.1622

_Current text

“Skin reactions with interferon beta are more common with subcutaneous administration and vary greatly in their clinical presentation”

_Suggested revision

“Skin reactions with interferon beta occur with both subcutaneous and intramuscular administration and vary greatly in their clinical presentation”

_Reason

Skin reactions occur with both Rebif and Avonex treatment.

_Suggested reference

Rebif EU Summary of Product Characteristics (July 2017). http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000136/WC500048681.pdf. Retrieved 26 July 2017

Avonex EU Summary of Product Characteristics (July 2017) http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000102/WC500029425.pdf. Retrieved 26 July 2017

_Current text

“Necroses appear in around 5% of patients and lead to the discontinuation of the therapy.”

_Suggested revision

“To reduce undesired effects at the injection site, it is recommended to rotate the site of injection. Necroses appear in ≤3% of patients and can lead to discontinuation of therapy. If necroses appear, medical advice should be sought.”

_Reason

Addition suggested to demonstrate how necroses can be avoided.

_Suggested reference

Rebif EU Summary of Product Characteristics (July 2017). http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000136/WC500048681.pdf. Retrieved 26 July 2017

Rebif US Prescribing Information (November 2015). http://www.emdserono.com/ms.country.us/en/images/Rebif_PI_tcm115_140051.pdf. Retrieved 26 July 2017

Avonex EU Summary of Product Characteristics (July 2017) http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000102/WC500029425.pdf. Retrieved 26 July 2017

Avonex US Prescribing Information (March 2016). https://www.avonex.com/content/dam/commercial/multiple-sclerosis/avonex/pat/en_us/pdf/Avonex_Prescribing_Information.pdf. Retrieved 26 July 2017

_Current text

“Necroses appear in around 5% of patients and lead to the discontinuation of the therapy.”

_Suggested revision

“To reduce undesired effects at the injection site, it is recommended to rotate the site of injection. Necroses appear in ≤3% of patients and can lead to discontinuation of therapy. If necroses appear, medical advice should be sought.”

_Reason

Text amended to match EU prescribing information.

_Suggested reference

Rebif EU Summary of Product Characteristics (July 2017). http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000136/WC500048681.pdf. Retrieved 26 July 2017

Rebif US Prescribing Information (November 2015). http://www.emdserono.com/ms.country.us/en/images/Rebif_PI_tcm115_140051.pdf. Retrieved 26 July 2017

Avonex EU Summary of Product Characteristics (July 2017) http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000102/WC500029425.pdf. Retrieved 26 July 2017

Avonex US Prescribing Information (March 2016). https://www.avonex.com/content/dam/commercial/multiple-sclerosis/avonex/pat/en_us/pdf/Avonex_Prescribing_Information.pdf. Retrieved 26 July 2017

_Current text

“Interferons, a subclass of cytokines, are produced in the body during illnesses such as influenza in order to help fight the infection”

_Suggested revision

Suggest adding a reference to support this claim.

_Reason

The claim is not currently referenced.

_Suggested reference

Perry AK, Chen G, Zheng D, Tang H, Cheng G (June 2005). "The host type I interferon response to viral and bacterial infections". Cell Research. 15 (6): 407–422. PMID 15987599. doi: 10.1038/sj.cr.7290309

_Current text

“Many patients report influenza-like symptoms hours after taking interferon beta that usually improve within 24 hours, being such symptoms related to the temporary increase of cytokines.”

_Suggested revision

Remove reference 10:

Compston A, Coles A (October 2008). "Multiple sclerosis". Lancet 372 (9648): 1502–17. doi:10.1016/S0140-6736(08)61620-7. PMID 18970977.

_Reason

The information is not included in reference 10, and is covered in reference 15.

_Current text

“Many patients report influenza-like symptoms hours after taking interferon beta that usually improve within 24 hours, being such symptoms related to the temporary increase of cytokines.”

_Suggested revision

“Many patients report influenza-like symptoms hours after taking interferon beta that usually improve within 24 hours, as they are related to the temporary increase of cytokines. In order to reduce side effects, Rebif and Avonex therapies are started on a lower dose and gradually increased to the full dose over 4 weeks.”

_Reason

To give the reader information on how to reduce the incidence of side effects.

_Suggested reference

Rebif EU Summary of Product Characteristics (July 2017). http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000136/WC500048681.pdf. Retrieved 26 July 2017

_Current text

“Another common transient secondary effect with interferon-beta is a functional deterioration of already existing symptoms of the disease.”

_Suggested revision

Suggest removing this text.

_Reason

The study references the use of interferon beta in patients with primary progressive MS (PPMS); however, interferon beta is not indicated for treatment of patients with PPMS. The text is not supported by data in RRMS.

_Current text

“Such deterioration is similar to the one produced in MS patients due to heat, fever or stress (Uhthoff's phenomenon), usually appears within 24 hours of treatment, is more common in the initial months of treatment, and may last several days”

_Suggested revision

Suggest removing this text.

_Reason

Uhthoff’s phenomenon is not listed in the US or EU interferon beta 1a labels, and the text does not relate to interferon beta-1a.

_Current text

“Nevertheless, recommendation is that all patients should be monitored through laboratory blood analyses, including liver function tests, to ensure safe use of interferon.”

_Suggested revision

“Nevertheless, it is recommended to monitor factors by carrying out tests including liver function tests, complete blood counts and alanine aminotransferase tests.”

_Reason

Text amended to match US and EU product labels.

_Suggested reference

Rebif EU Summary of Product Characteristics (July 2017). http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000136/WC500048681.pdf. Retrieved 26 July 2017

Rebif US Prescribing Information (November 2015). http://www.emdserono.com/ms.country.us/en/images/Rebif_PI_tcm115_140051.pdf. Retrieved 26 July 2017

Avonex EU Summary of Product Characteristics (July 2017) http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000102/WC500029425.pdf. Retrieved 26 July 2017

Avonex US Prescribing Information (March 2016). https://www.avonex.com/content/dam/commercial/multiple-sclerosis/avonex/pat/en_us/pdf/Avonex_Prescribing_Information.pdf. Retrieved 26 July 2017

Plegridy EU Summary of Product Characteristics (January 2017). http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/002827/WC500170302.pdf. Retrieved 26 July 2017

Plegridy US Prescribing Information (October 2015). https://www.plegridy.com/content/dam/commercial/multiple-sclerosis/plegridy/pat/en_us/pdf/november/plegridy-prescribing-information.pdf. Retrieved 26 July 2017

_Current text

“Side effects are often onerous enough that many patients ultimately discontinue taking Interferons (or glatiramer acetate, a comparable disease-modifying therapies requiring regular injections).”

_Suggested revision

“Side effects may be onerous enough that 2–27% of patients ultimately discontinue taking interferon beta-1a.”

_Reason

The text is not currently supported by references.

_Suggested reference

Nikfar S, Rahimi R, Abdollahi M (October 2010). "A meta-analysis of the efficacy and tolerability of interferon-β in multiple sclerosis, overall and by drug and disease type". Clinical Therapeutics. 32 (11): 1871–1888. PMID 21095482. doi: 10.1016/j.clinthera.2010.10.006

_Current text

“Interferon beta balances the expression of pro- and anti-inflammatory agents in the brain and reduces the number of inflammatory cells that cross the blood brain barrier.”

_Suggested revision

“Interferon beta increases production of anti-inflammatory agents and inhibits production of pro-inflammatory agents in the brain. It also reduces the number of white blood cells that cross the blood–brain barrier and stimulates the production of trophic factors that mediate tissue repair.”

_Reason

Reworded to more accurately reflect the reference.

‘Inflammatory cells’ changed to ‘white blood cells’ to reflect the reference.

‘Trophic factors’ included to match the reference.

_Suggested reference

No change to the reference

_Current text

“Overall, therapy with interferon beta leads to a reduction of neuron inflammation. Moreover, it is also thought to increase the production of nerve growth factor and consequently improve neuronal survival.”

_Suggested revision

“Overall, therapy with interferon reduces neuron inflammation and increases the production of nerve growth factor, consequently improving neuron survival.”

_Reason

Reworded to make the text easier to read.

_Current text

“Rebif is administered via subcutaneous injection three times per week, and can be stored at room temperature for up to 30 days.”

_Suggested revision

“Rebif is administered via subcutaneous injection three times per week. Rebif can be stored at room temperature for up to 30 days according to US FDA Prescribing Information, and at 25°C or below for 14 days according to the EU Summary of Product Characteristics. Further storage information can be found in the US and EU product labels.

A range of Rebif injection devices are available:

• RebiSmart (outside the US), an electronic autoinjector system that uses weekly cartridges and offers an included injection calendar, personalized setting options.

• RebiDose, a prefilled single-use autoinjector.

• Rebiject II, an autoinjector for use with prefilled syringes.

• RebiSlide, a manual injection system (available in Canada).”

_Reason

Changes suggested for accuracy.

_Suggested reference

Rebif EU Summary of Product Characteristics (July 2017). http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000136/WC500048681.pdf. Retrieved 26 July 2017

Rebif US Prescribing Information (November 2015). http://www.emdserono.com/ms.country.us/en/images/Rebif_PI_tcm115_140051.pdf. Retrieved 26 July 2017

_Current text

“Rebif is administered via subcutaneous injection three times per week, and can be stored at room temperature for up to 30 days.”

_Suggested revision

“Rebif is administered via subcutaneous injection three times per week. Rebif can be stored at room temperature for up to 30 days according to US FDA Prescribing Information, and at 25°C or below for 14 days according to the EU Summary of Product Characteristics. Further storage information can be found in the US and EU product labels.

A range of Rebif injection devices are available:

• RebiSmart (outside the US), an electronic autoinjector system that uses weekly cartridges and offers an included injection calendar, personalized setting options.

• RebiDose, a prefilled single-use autoinjector.

• Rebiject II, an autoinjector for use with prefilled syringes.

• RebiSlide, a manual injection system (available in Canada).”

_Reason

Information on Rebif devices suggested for consistency with the Avonex section.

Hyperlinks suggested to provide the user with further information from further Wikipedia pages.

_Current text

“A more water-soluble variant is currently being investigated by the Vakzine Projekt Management (VPM) GmbH in Braunschweig, Germany.”

_Suggested revision

“A more water-soluble variant is currently being investigated by the Vakzine Projekt Management (VPM) GmbH in Braunschweig, Germany. However, this drug is not approved for treatment of MS.”

_Reason

Text added for clarity.

_Suggested reference

Vakzine Projekt Management. http://www.vakzine-manager.de/en/resources/Produkte/VPM5001_en.pdf. Retrieved on 26 July 2017

_Current text

“Interferon beta 1b is marketed only by Bayer in the US as Betaseron and outside the US as Betaferon.”

_Suggested revision

“Interferon beta-1b is marketed by Bayer in the US as Betaseron, and outside the US as Betaferon (Bayer) and Extavia (Novartis).”

_Reason

Updated the text to include Extavia.

_Suggested reference

1. Betaferon® Summary of product characteristics. https://www.medicines.org.uk/emc/medicine/1809. Accessed 16 October 2017

2. Betaseron® US prescribing information. http://labeling.bayerhealthcare.com/html/products/pi/Betaseron_PI.pdf. Accessed 16 October 2017

_Current text

“This is because it requires a refrigerated chain of distribution and costs $17,000-a-year.”

_Suggested revision

Suggest removing this text.

_Reason

It is not clear from the text which drug is being referred to, and the information is not supported by the reference.

_Current text

Categories: Pfizer products

_Suggested revision

Suggest removing the link to the ‘Pfizer’ page.

_Reason

Pfizer is no longer involved in the marketing of interferon beta-1a.

--Florian Schaub at Merck KGaA (talk) 07:56, 24 October 2017 (UTC)

If you see significant errors we will fix them. With respect to minor changes we likely will not. Please only raise significant issues. Thanks Doc James (talk · contribs · email) 16:56, 24 October 2017 (UTC)

We don not expect you to edit the article. We would change the article on our own and update major and minor issues. Please let us know if this is alright. --Florian Schaub at Merck KGaA (talk) 10:40, 7 November 2017 (UTC)

second paragraph sounds contradictory

Interferon beta has not been shown to slow the advance of disability.[4][5][6][7] Interferons are not a cure for MS (there is no known cure); the claim is that interferons may slow the progress of the disease if started early and continued for the duration of the disease.

This is right at the beginning of the article and sorta highlights the crux of this medication. I just think this should be written a little more straight. Like, the literature is split on whether [x] or not [4][5][6][7] Intereron beta slows the progression of disease and disability in MS. — Preceding unsigned comment added by 2607:FEA8:3C20:111A:BB:231B:3A69:87EA (talk) 23:07, 28 August 2018 (UTC)

Perhaps a change to something like

"a majority of literature supports the use of interferon's in slowing progression of MS and frequency of flare-ups, with increased utility being found with prolonged treatment. The research is currently considered inconclusive however, with several studies showing interferon having no effect on reducing the progression of MS" 

With the relevant sources linked. currently 3/4 of the sources for the claim that they do not slow the progression state that they do, being linked to support a position which they do not. This is also supported by a more recent study(5/19) than those linked. If the original author had intended to show the controversy in doing this, it was a poor method. As i intend to fix the dispute, i would also move the sources to align with their corresponding viewpoint. i would like to edit the article to be more truthful,but im unfamiliar with the customs of editing so ill wait for a time before doing so to see if theres any objections or suggestions. study:

Mybestunderstanding (talk) 00:18, 13 June 2020 (UTC)

References