Haematological Effects of Interferon-??-1a (Rebif??) Therapy in Multiple Sclerosis

Rieckmann, Peter; O’Connor, Paul; Francis, Gordon; Wetherill, Graham; Alteri, Enrica

doi:10.2165/00002018-200427100-00005

Cited by 73 publications

(48 citation statements)

References 30 publications

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“…In 2 systematic reviews examining hepatic dysfunction in patients receiving IFN β-1a SC tiw that used data from randomized controlled clinical trials and postmarketing surveillance studies, raised hepatic aminotransferase levels were predominately asymptomatic, tended to occur early (within the first 12 months) in treatment, and often were resolved spontaneously or with dosage adjustment. 36,37 Other serious AEs, including Stevens-Johnson syndrome, TTP/HUS, drug-induced lupus erythematosus, autoimmune hepatitis, and urticaria, showed uniformly low IRs. RÍo et al (2005), in an 8-year follow-up study of IFN β patients, found 3 cases of urticaria and angioedema in those taking IFN β-1a SC tiw.…”

Section: ■■ Discussionmentioning

confidence: 99%

Postmarketing Safety Profile of Subcutaneous Interferon Beta-1a Given 3 Times Weekly: A Retrospective Administrative Claims Analysis

Smith

Sabidó-Espin²,

Trochanov³

et al. 2015

JMCP

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Section: ■■ Discussionmentioning

confidence: 99%

Postmarketing Safety Profile of Subcutaneous Interferon Beta-1a Given 3 Times Weekly: A Retrospective Administrative Claims Analysis

Smith

Sabidó-Espin²,

Trochanov³

et al. 2015

JMCP

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“…5,44 During the first 6 months of therapy, IFNβ-1a SC was found to be associated with a generally mild doserelated increase in leukopenia, lymphopenia, granulocytopenia, and thrombocytopenia (P < .0001) but not anemia. 45 Leukopenia and lymphopenia were observed in 20% and 29% of patients receiving IFNβ-1a 22 µg SC and 13% and 22% of patients receiving IFNβ-1a 44 µg SC, respectively, over the first 2 years of treatment and 27% and 35% of patients receiving IFNβ-1a 22 µg SC and 16% and 23% of patients of patients receiving IFNβ-1a 44 µg SC, respectively, after 4 years of treatment. 5 After 6 years of follow-up, leukopenia was observed in 14% and lymphopenia in 20% of patients treated with IFNβ-1a SC, most of which was mild.…”

Section: Disease-modifying Therapies Ifnβ β and Glatiramer Acetatementioning

confidence: 97%

Review: Optimizing Adherence to Multiple Sclerosis Therapies

B¹,

Lucas²,

Kresa-Reahl³

et al. 2008

International Journal of MS Care

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Disease-modifying drugs (DMDs) have transformed the treatment of relapsing-remitting multiple sclerosis (RRMS). Several studies have shown the benefits of long-term treatment in RRMS; however, all multiple sclerosis (MS) therapies are associated with treatment-related tolerability and safety issues that may challenge patient compliance with therapy. Tolerability issues include flulike symptoms and injection-site reactions for interferon β(IFNβ) and lipoatrophy and systemic postinjection reactions for glatiramer acetate (GA). Altered blood cell counts, depression, and elevated liver enzymes, including rare cases of acute liver injury, are safety issues that have been associated with IFNβand, rarely, systemic anaphylactoid reactions with glatiramer acetate. Common tolerability issues associated with natalizumab are hypersensitivity and postinfusion reactions, and mitoxantrone may cause amenorrhea, nausea, and alopecia. Serious safety issues that have limited the use of natalizumab and mitoxantrone as first-line treatments are progressive multifocal leukoencephalopathy for natalizumab and cardiotoxicity and leukemia for mitoxantrone. Although both tolerability and safety issues can affect patient adherence to therapy, numerous strategies are available to manage tolerability and monitor safety issues. Through careful monitoring of treatment-related safety issues, patient education, and tolerability management strategies, treatment nonadherence can be minimized, thereby maximizing the treatment benefits of DMDs.

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“…Severe leukopenia, lymphopenia and neutropenia are uncommon. These alterations are usually early (within 3 months), asymptomatic and not associated with increased risk of infection [15]. The phenomenon is entirely peripheral, with normal bone marrow, as a redistribution of blood cells.…”

Section: Changes In Biochemical Parameters During Therapy With Diseasmentioning

confidence: 99%

Biochemical Parameters Alterations in Multiple Sclerosis: A Longitudinal Study and Review of the Literature

Orefice

Ferraro²,

Barbato³

et al. 2012

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Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) and is characterized by inflammation, demyelination and desctruction of oligodendrocytes and axons. The immunology of MS is complex, involving autoreactive Th1 and Th17 lymphocytes, cells of the innate immune system including dedritic, natural killer (NK) and microglia cells, as well as vascular endothelial cells. Multiple Sclerosis (MS) is based by a series of biochemical changes affecting to different extent neuronal functions; great attention has been focused on: liver enzymes, thyroid function tests, autoantibodies, lipid profile and uric acid levels. Following the introduction of therapy with drugs that modify the course of disease, more attention has been paid to the change of biochemical parameters, in particular to evaluate possible adverse effects. Aim of this study was to perform a review of the literature on biochemical alterations in treated and untreated MS patients and to assess laboratory parameters alterations in a cohort of MS patients, before and during treatment. On a total of 624 patients followed at our center, we selected those who practiced for the first time a therapy with IFN beta 1a at various doses, IFN beta 1b and Glatiramer acetate, that were 595 (95%), with baseline biochemical evaluation available in 488 (82%) (307 females, mean age 36.6 years). We considered the evolution of various biochemical parameters during treatment. The following outcome variables were evaluated: laboratory changes, in particular liver function, thyroid function, lipids and blood cell count. Percentages were compared using the chisquare test. ANOVA was performed to evaluate changes of laboratory tests over time between therapy groups. Our finding confirm the presence of biochemical alterations at baseline, in particular regarding liver enzymes, thyroid hormones and lipids. Treatment effects were more evident on liver enzymes elevation, anti thyroid antibodies production and blood cholesterol decrease. These effects were mainly transient and self remitting without suspension of therapy. Biochemical alterations, mainly related to autoimmune pathology and lipid metabolism change were encountered. Treatments increased transient biochemical alterations particulary in patients with baseline changes, suggesting a stricter monitoring of blood exams in this category of patients.

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Haematological Effects of Interferon-??-1a (Rebif??) Therapy in Multiple Sclerosis

Cited by 73 publications

References 30 publications

Postmarketing Safety Profile of Subcutaneous Interferon Beta-1a Given 3 Times Weekly: A Retrospective Administrative Claims Analysis

Postmarketing Safety Profile of Subcutaneous Interferon Beta-1a Given 3 Times Weekly: A Retrospective Administrative Claims Analysis

Review: Optimizing Adherence to Multiple Sclerosis Therapies

Biochemical Parameters Alterations in Multiple Sclerosis: A Longitudinal Study and Review of the Literature

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