Disease Modifying Therapies: ABC

Oh the drugs they have come out with for MS has been glorious recently. Before the 1990s all there was for treating MS were steroids and chemotherapies. How archaic! Lets start with the first Disease Modifying Therapies (DMTs): The ABCs, and the first one, the A for Avonex, is what I used in the past so I’ll describe that one specifically. B for betaseron. C for Copaxone.
The ABCs are interferons. Inteferons are signaling proteins that are released when a pathogen is introduced to the body so that other cells will increase their anti-pathogen resistance. Effectively, it’s a messenger that tells to the body to spring into action. In MS, the inteferons are put into the body to hopefully combat the progression of MS in some mysterious way. All I really know about Avonex is that its harvested from mice ovaries in China. Then I belive it is reconstituted with human DNA and shipped to your door to treat your MS. A gross oversimplification, yes, but it effectively conveys my knowledge of Avonex.
The route of administration is not a fun one if you do not like needles/injections. With the ABCs you’ll actually receive a kit for sticking yourself every so often to administer the medication. I however, am not able to stick myself with a needle. I just can not bring myself to do it, self-preservation I suppose. I’ve tried and tried sitting there with the needle, deciding where to stick it, and ultimately deciding that nope, I can not do this. Luckily my wife, the MR tech, has experience with sticking people, so she was able to stick me and relieve me from that duty. For which I am forever thankful.
Now, you’ve had the drug administered. You feel fine after the injection. Then you get up the next day feeling like you have the flu.¬† That is the interferon doing it’s thing. And a pleasant experience it is not. Dr. K would suggest that I take 800mg of ibuprofen before the shot and then continue through the flu-like symptoms. Didn’t help much, plus I’d occasionally make the mistake of forgetting I took the ibuprofen and double up on the dose making it a 1.6g dose of ibuprofen. I think that overdosing ibuprofen actually messed me up or caused an allergy as I get a hard and painful lump between my upper lip and nose (I believe it’s called the¬†philtrum). To this day I will not take ibuprofen. I even made the mistake of telling an ER doctor that I’m allergic to ibuprofen when she tried prescribing it. I automatically got turfed as drug seeking, I could see it in the doctor’s eyes. What I should have said is I suspect a ibuprofen allergy as I get a lump in my philtrum every time I take it. Live and learn. But I digress…
Here is the advice the great Dr. K gave me for administering Avonex:

  • Drink LOTS of water – something I still do to this very day – a good thing
  • Ice the injection site for 30 minutes prior to injection
  • Premedicate with ibuprofen to lessen the side effects. Keep it up through the duration of side-effects.

Also, there is a plus side to the ABCs. They will prevent you from getting colds or at least reduce the symptoms. I remember when I was taking Avonex and everybody else in the house would be down with a severe cold, I’d be continuing life as normal. You have to see the good and bad!
Now back to the current time. I did not achieve the desired results with the ABCs, so I was pulled off Avonex, given an eight week drug holiday, and was switched to my next drug Tysabri.