Rebif (interferon beta-1a)


Rebif (interferon beta-1a) is an injectable disease-modifying treatment for people diagnosed with MS, manufactured by EMD Serono and co-marketed by EMD Serono and Pfizer. Rebif is indicated (approved for use) for the treatment of relapsing forms of MS to reduce frequency of exacerbations and slow the progression of disability.


How does Rebif work?

Rebif is an interferon, a family of glycoproteins produced naturally in the body in response to viral infection or invasion of the body by another biologic agent. Rebif, produced through a biotechnological process using mammalian cells containing naturally occurring interferon, contains all of the same basic components as the interferon beta occurring naturally in the human body.

The exact process by which Rebif and other interferon beta drugs work to reduce the frequency of exacerbations and slow the progression of disability in MS is unknown. However, as interferons play an important role in controlling immune system activities, Rebif may use its ability (as an interferon) to control the abnormal immune response that appears to be involved in MS. When Rebif is given to a person, levels of several pro-inflammatory cytokines that play a role in the immune system response are decreased.


How is Rebif taken?

Rebif is given as a subcutaneous (under the skin) injection three times a week, for example, every Monday, Wednesday, and Friday at the same time each day. The effective doses of Rebif are 22 micrograms or 44 micrograms (µg or mcg). Doses of Rebif must be separated by at least 48 hours.

When starting Rebif, you will only take 20% of the recommended dose and work up gradually over the course of 4 weeks to the full dose (either 22 µg or 44 µg).

Your doctor or another qualified health professional will train you on how to give yourself injections of Rebif. You can also find useful information about administration of Rebif by visiting the manufacturer website.

Because flu-like symptoms are common with interferon beta medications like Rebif, it is recommended that you administer the drug at bedtime. Over-the-counter medications to treat pain and fever associated with flu, such as acetaminophen (Tylenol) or ibuprofen (Advil), may be taken 30 minutes before your Rebif injection and 24 hours following your injection to help control these symptoms.


What if I miss a dose of Rebif?

If you miss a dose of Rebif, take your next dose as soon as you remember and skip the following day. DO NOT take Rebif on 2 consecutive (back to back) days. Return to your regular schedule of injections the following week. If you take Rebif on consecutive days by mistake, call your doctor immediately.


How should Rebif be stored?

Rebif should be stored in a refrigerator (36ºF to 46ºF). However, Rebif can be stored at room temperature (at or below 77ºF) for up to 30 days, if it is not exposed to heat or light. Do not allow Rebif to freeze.


Are there people who should not take Rebif?

Rebif should not be taken by persons who have had a previous allergic reaction to an interferon beta medication, such as itching, hives, difficulty breathing (dyspnea), and flushing, or a history of hypersensitivity to albumin.

If you have had problems with depression, thyroid gland  problems, blood problems (such as bleeding, easy bruising, anemia, or low white blood cell counts), epilepsy, liver disease, or are planning to become pregnant, you should talk to your doctor before starting Rebif. Rebif can cause serious side effected related to each of the conditions previously mentioned. Tell your doctor about all medications and supplements you are taking, including vitamins and herbal preparations, before starting Rebif.

You should avoid becoming pregnant while taking Rebif, as it may cause miscarriage. If you should become pregnant while taking Rebif, stop taking the drug immediately and talk to your doctor. Talk to your doctor about whether you should breast feed while taking Rebif, as it is not known whether Rebif is passed through breast milk or if it can harm your baby.


What evidence do we have that Rebif works?

Rebif was compared with placego in two clinical trials to determine how effective it was in reducing the frequency of relapses and slowing the progression of disability in people with relapsing-remitting MS (RRMS). The first study was a 2-year randomized, double-blind, placebo-controlled trial in people who had had MS for at least 1 year, had a certain level of disability as measured by the Expanded Disability Status Scale (EDSS), and had at least 2 relapses in the two years before the study. Rebif resulted in a significant decrease in the frequency of exacerbations and a significant increase in the time it took for disability to progress in persons with RRMS compared with placebo. People who received Rebif also had fewer active brain lesions and significant decreases in the volume of brain lesions at 2 years as seen by magnetic resonance imaging (MRI).

The second study, known as the EVIDENCE trial, was a randomized, open-label, active-controlled study in which Rebif was compared with the interferon beta medication Avonex. The study lasted 48 weeks. People who received Rebif were more likely to be free of relapses at 24 and 48 weeks after beginning treatment compared with those who received Avonex.


Is there a generic alternative to Rebif?

There is no generic alternative to Rebif. However, the drug Avonex (interferon beta-1a), a intramuscular injectable medication given once per week made by Biogen Idec, contains the same active ingredient as Rebif.