Notes for: Other Immunomodulating DrugsLast edited [27/06/2012 10:08:59]
With interferon the patient may experience symptoms of a flu-like illness and headaches, more common with the start of treatment and reduce with continued use. Dizziness, pins and needles, trembling, numbness, sleep disturbances, anxiety states, forgetfulness, drowsiness, confusion, depression, and suicidal behaviour have occurred.
Last edited [27/06/2012 10:48:04]Last edited [27/06/2012 10:55:20]Interferon Alfa
NICE guidance Peginterferon alfa, interferon alfa and ribavirin for chronic hepatitis C
TA106 'Hepatitis C - peginterferon alfa and ribavirin peginterferon alfa and ribavirin'
TA200 'Hepatitis C - peginterferon alfa and ribavirin peginterferon alfa and ribavirin'
TA75 'Interferon alfa (pegylated and nonpegylated) and ribavirin for the treatment of chronic hepatitis C'
Interferon Beta
NICE guidance (interferon and glatiramer for multiple sclerosis) (January 2002) does not recommend either interferon beta or glatiramer acetate for the treatment of multiple sclerosis in the NHS in England and Wales.
NICE guidance (No. 127) Natalizumab for multiple sclerosis (August 2007) recommends that natalizumab is recommended as a possible treatment for people with rapidly evolving severe relapsing-remitting multiple sclerosis. NICE guidance on fingolimod in relapsing remitting multiple sclerosis (TAG 254, April 2012)
MHRA Drug Safety Update (May 2012) Fingolimod is not recommended in patient groups at high risk of cardiovascular adverse events, such as those with significant QT prolongation or history of bradycardia, ischaemic heart disease, cardiac failure, cerebrovascular disease, uncontrolled hypertension, and those receiving antiarrhythmic or heart-rate lowering drugs. Monitoring advice after the first dose has been updated.
MHRA Drug Safety Update (Jan 2013) Cardiovascular monitoring requirements for Fingolimod if treatment is interrupted and restarted.
MHRA Drug Safety Update (Mar 2010) advises The risk of developing progressive multifocal leukoencephalopathy (PML) with natalizumab increases after 2 years of therapy. Patients with multiple sclerosis should be informed of the risk before treatment, and again after 2 years. The risk of developing PML beyond 3 years of treatment is currently unknown.