Other names: interferon beta 1b
You self-inject Extavia under the skin every other day to reduce the number and severity of relapses. It reduces the number of relapses by about one third (30%), compared to placebo.
Common side effects include flu-like symptoms and injection site reactions.
What is Extavia used for in MS?
Extavia is a disease modifying drug for relapsing MS. You have fewer relapses than you might have had with no treatment and any relapses you do have should be less severe. It can also be used after a first episode of neurological symptoms (clinically isolated syndrome) to delay conversion to multiple sclerosis.
Extavia is a moderately effective (category 1.1) DMD; in clinical trials people taking Extavia had about 30% fewer relapses than people taking placebo. In clinical trials, MRI scans showed people taking Extavia had fewer, smaller or no new areas of active MS (lesions). Extavia may also slow down the build-up of disability associated with MS.
Who can take Extavia?
Extavia can be prescribed for adults with active relapsing remitting MS and for people with secondary progressive MS who continue to have disabling relapses.
Extavia can also be prescribed for people who have had a first episode of neurological symptoms (clinically isolated syndrome) and have a high risk of developing MS.
Extavia has been approved for use on the NHS since 2009. It can only be prescribed by a neurologist.
It's important that you tell your MS team if you have any health problems or are taking other medicines. Extavia may not be suitable if you have severe depression or suicidal thoughts.
Conception and pregnancy
Pregnancy is not recommended during treatment.
If you are trying for a family, talk to your MS nurse or neurologist about whether you should continue to take Extavia until you are pregnant.
If you become pregnant while on Extavia, your neurologist or MS nurse may recommend you stop taking it.
How do I take Extavia?
You self-inject Extavia under the skin every other day.
Your MS nurse will show you how to do the injections, discuss the practicalities and offer advice or training and ongoing support if you should need it.
To give your body a chance to get used to Extavia and reduce the impact of side effects, your doctor or MS nurse may suggest you start on a lower dose and gradually increase to the full dose.
What side effects could I get with Extavia?
The most common side effects include:
- Flu-like symptoms, such as headache, muscle ache and stiffness, chills or fever, following an injection
- Injection site reactions
You are more likely to have these side effects when you first start taking Extavia. Most people have mild to moderate side effects which tend to go away over time.
A neurologist or MS nurse may suggest ways to reduce these side effects including:
- To help with flu-like symptoms, it may be helpful to change the time of day of injection in order to sleep through the worst of the side effects
- To help reduce fever, paracetamol or ibuprofen can be taken before the injection and at four to six hour intervals after the injection, as required
Common side effects (affecting more than 1 person in 100)
- flu-like symptoms
- injection site reactions
- blood cell abnormalities
- feeling weak or tired
- difficulty sleeping
- diarrhoea, nausea and vomiting
- muscular or joint pain
Less common side effects (affecting less than 1 person in 100)
- changes in menstruation (periods)
- neurological symptoms, mood changes, depression
- liver abnormalities
- allergic reactions
- heart problems and hypertension
- hair thinning or loss
- damage to small blood vessels leading to kidney problems
A full list of side effects is included in the manufacturer's Patient Information Leaflet.
Assessment before treatment
Before starting Extavia, you should have blood tests to measure blood cell counts and check liver function.
Assessment during treatment
Once you've started treatment, you'll have blood tests to measure blood cell counts and monitor liver function, generally every three months for the first year, then less frequently. Depending on local practice, the tests may be carried out at a local GP surgery or it may be necessary to attend a hospital clinic.
As Extavia is very similar to Betaferon, no additional studies were needed. The following study first demonstrated the effectiveness of Betaferon:
- The IFNB Multiple Sclerosis Study Group - Betaferon compared to placebo
This clinical trial compared two doses of Betaferon or placebo in 372 people with relapsing remitting MS. Compared with placebo, the higher dose of Betaferon reduced the relapse rate by 31% over the 2 year study. Disability levels measured by EDSS changed very little in treatment and placebo groups. The higher dose of Betaferon reduced the number of brain lesions on MRI.
The use of Extavia over 10 years has been studied as part of the Risk-sharing scheme in the UK.
- NICE technology appraisal guidance TA32 Full guideline Beta interferon and glatiramer acetate for the treatment of multiple sclerosis
- Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. I. Clinical results of a multicenter, randomized, double-blind, placebo-controlled trial. The IFNB Multiple Sclerosis Study Group. Neurology 1993;43(4):655-61. Summary
Compare Disease Modifying Drugs
Use our MS Decisions aid to help filter and compare the different types of disease modifying drugs (DMDs) that are available to treat relapsing MS.
Disease modifying drugs
If you are considering treatment with one of the disease modifying drugs for relapsing MS, this book will help you to understand how the drugs work and to have informed discussions with your health team about your treatment options.
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