Interferon beta-1a (Rebif) for MS: Potential COVID-19 Drug

What is interferon beta-1a (Rebif), and what is it used for?

Interferon beta-1a (Rebif) is a protein produced by recombinant DNA technology using genetically engineered Chinese Hamster Ovary Cells into which the human interferon beta genes have been introduced. It is used for treating multiple sclerosis (MS). Interferon beta-1a is designed to be identical to interferon beta that is naturally produced by various cells in the body. Interferon beta has antiviral properties and plays a role in regulating the immune response. The exact mechanism by which interferon beta-1a works in the body to treat MS is not known. Interferon beta-1a does not cure MS. Rather, it helps to decrease the number of flare-ups and slows the occurrence of some of the physical disability that commonly occurs in the disease. Rebif was first approved by the FDA in 1996.

What brand names are available for interferon beta-1a (Rebif)?

Rebif

Is interferon beta-1a (Rebif) available as a generic drug?

Do I need a prescription for interferon beta-1a (Rebif)?

Yes

Can interferon beta-1a be used to treat the COVID-19 coronavirus?

Interferon beta-1a, currently in use to treat multiple sclerosis, and interferon alfa-2b are both under investigation as potential treatments for people with COVID-19 coronavirus disease, the deadly respiratory pandemic caused by the SARS-nCoV-2 virus.

Essentially, when confronted with a virus, each cell shoots an emergency flare of interferon to tell the immune system to marshall its defenses.
Interferon Beta 1a, specifically, activates macrophages that engulf antigens and natural killer cells (NK cells), a type of immune T-Cell.
Those cells are integral in the innate immune system.
The theory is, interferon may be able to make the immune system stronger by turning on dormant parts and directing them toward the defense against SARS-nCoV-2's assault.

The problem is, when interferons ramp up the immune system, COVID-19's flu-like symptoms are likely to become worse before they get better; interferon naturally occurring in the body is responsible for all flu-like symptoms to begin with, whether you have the coronavirus or a common cold.

So, if someone is already on a ventilator and symptoms are about to overwhelm them, giving them an interferon-based medicine could be catastrophic. This is why interferon therapies for viral infections are typically a last resort — the potential for dire side effects.

Studies around the world, including a huge WHO study, are looking at different interferons to treat COVID-19 coronavirus, but no existing COVID-19 drug trials in the U.S. included interferons as of April 7, 2020.

It is possible there is a hesitance to use interferon in America because it was used in the late 1990s and early 2000s to treat Hepatitis C, and its side effects caused a lot of injury to U.S. patients.

Clinicians were lucky if they saw a 30% cure rate treating Hep C with interferon, but the side effects were severe, including:

Drop in white blood cell levels,
liver problems, and
psychiatric issues.

People would become suicidal, fall into deep depressions.

Data for COVID-19 section provided by Dominic Chan, a Pharm. D. and infectious disease specialist at Legacy Health System in Oregon.

What are the side effects of interferon beta-1a (Rebif)?

The most common side effects of interferon beta-1a are:

injection site reactions,
flu-like symptoms,
headache,
muscle aches,
nausea,
pain,
fever,
diarrhea, and
infections.

Flu-like symptoms are commonly
experienced when patients first start taking interferon beta-1a. These symptoms
can be managed with over-the-counter pain and fever reducers, and usually
decrease or go away over time.

Stomach pain, an increase in liver enzymes, and blood disorders including a
drop in the number of red blood cells, white blood cells, and platelets also may
occur.

Interferon beta-1a may also cause other serious side effects including
seizures, suicidal thoughts or actions, liver disease, and serious allergic and
skin reactions.

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What is the dosage for interferon beta-1a (Rebif)?

The recommended dose of Rebif is either 22 mcg or 44 mcg injected
subcutaneously three times per week. It should be administered around the
same time each week on the same three days of the week at least 48 hours apart.

The best sites to inject are the areas of the body that usually have more
fatty tissue like the thigh, the outer surface of the upper arm, stomach, or
buttocks. Avoid injecting around the waistlines or within 2 inches of the navel.
To prevent injury, patients who are very thin should only inject the thigh or the
outer surface of the arm.

Which drugs or supplements interact with interferon beta-1a (Rebif)?

Combining interferon beta-1a with zidovudine (Retrovir) or
hydroxyurea (Hydrea) may increase the risk of bone marrow suppression.

Is interferon beta-1a (Rebif) safe to take if I’m pregnant or breastfeeding?

Use of interferon beta-1a has not been adequately evaluated in
pregnant women. Due to the lack of conclusive safety data, interferon beta-1a
should be used in pregnancy only if the potential benefit justifies the
potential risk to the fetus. Interferon beta-1a is classified as FDA pregnancy
risk category C (animal studies show an adverse effect on the fetus).

It is not known if interferon beta-1a is excreted in breast milk. As many drugs enter breast milk and can potentially cause harm to the
nursing infant, interferon beta-1a should be used cautiously in nursing mothers.

What else should I know about interferon beta-1a (Rebif)?

What preparations of interferon beta-1a (Rebif) are available?

Injection: 8.8 mcg/0.2 ml, 22 mcg/0.5 ml, and 44 mcg/0.5 ml in single-dose
prefilled syringe or single-dose autoinjector.

How should I keep interferon beta-1a (Rebif) stored?

Preferably interferon beta-1a should be stored refrigerated between
2 C to 8 C (36 F to 46 F). If needed, interferon beta-1a can be stored between 2
C to 25 C (36 F to 77 F) for up to 30 days.