Self-injection
There are many factors to consider when selecting a disease-modifying therapy for MS. Lifestyle is one of those factors to consider. Part of that consideration is how convenient and easy a disease-modifying drug (DMD) is to administer.
All of the disease-modifying therapies currently approved by Health Canada are injectables. The following DMDs are given by self-injection, meaning you can administer the drug yourself, or with the assistance of a friend or family member, at home:
- Avonex® (interferon beta-1a)
- Betaseron® (interferon beta-1b)
- Copaxone® (glatiramir acetate)
- Rebif® (interferon beta-1a)
These medications are given by two methods: subcutaneously (just under the skin) or intramuscularly (into the muscle layer). A fifth disease-modifying therapy approved for use (Tysabri® [natalizumab]) is given intravenously at a clinic where a 1 hour infusion is done under medical supervision.
Most patients dislike injections, especially the thought of self-administering them. Common reactions can include anxiety, fear, avoidance and autonomic reaction (physical changes in response to anxiety) (1), however your healthcare team will provide injection training and support as you learn to become more comfortable with self-injection. In addition, the manufacturers of these medications offer support programs to help you learn how to self-inject comfortably, and effective tools are becoming available to help with self-injection anxiety. One such technological advancement is the new RebiSmart™—an innovative, personalized electronic self-injection device for administration of Rebif® (interferon beta-1a). This is the first device of its kind in this disease state and was specifically designed for ease of use. Its on-screen instructions and signals guide patients through the injection process, and individually adjustable comfort settings give people more flexibility with injection duration and depth, helping minimize discomfort and pain. To learn more about RebiSmart™ and how it helps you to get the most out of MS therapy, click here.
In some cases, patients' reactions make it extremely difficult or impossible to receive injections (1) if you think you will have difficulty giving yourself injections, it is important to bring along a care partner who can learn alongside you to give you your medication.
Self-injection = independence
Self-injection allows you to have maximum independence and reduces the risk of missed injection or drug discontinuation (1), meaning you can stay on therapy and maximize the benefits of treatment. To learn more about the importance of treatment adherence, click here.
There are a few side effects that can be associated with self-injection, commonly referred to as injection-site reactions; however your healthcare team and the support systems from the manufacturers can provide you with tips on how to manage these. An injection site reaction can include:
- Swelling
- Redness
- Discolouration
- Pain
These occur only at the injection site and typically disappear within a few days of administration and usually improve over time as you continue with your therapy. Click here to learn how to manage injection-site reactions.
Self-injection has been made easier with the development of new injection devices, primarily autoinjectors, which have largely replaced the syringe and needle method. An autoinjector is a device that contains a cartridge of medicine, a needle and usually a needle cover. An injection is delivered with a push of a button—this automatically inserts the needle, injects a single dose of the medicine, and then retracts the needle back into the device. The use of an autoinjector device has been shown to improve the tolerability of interferon beta-1a in multiple sclerosis patients.(2)
The most recent development in MS therapy self-administration is RebiSmart™, an innovative advancement that helps you get the most out of your MS treatment in one, personalized, easy-to-use injection device. Not only does the needle remain hidden during the entire injection process, the on-screen prompts and comfort settings help simplify and lessen the anxiety associated with self-injection.(1)
Click here to view a summary of the available autoinjectors for MS therapies.
At no time should the information presented replace or supersede the recommendations of your own physician. If you have any concerns, please take the information or questions to your physician.
References:
1. Cox D, Stone J. Managing Self-Injection difficulties in patients with relapsing-remitting multiple sclerosis. J Neurosci Nurs. 2006;38(3):167-71.
2. Mikol D, et al (Rebiject Study Group). A randomized, multicentre, open-label, parallel-group trial of the tolerability of interferon beta-1a (Rebif) administered by autoinjection or manual injection in relapsing-remitting multiple sclerosis. Mult Scler. 2005;11(5):585-91.
