Extavia

Extavia can only be obtained with a prescription and treatment should be started by a doctor who has experience in the treatment of MS.

Extavia is available as a powder and solvent that are made up into a solution that supplies a dose of 250 micrograms. It is given by injection under the skin.

Treatment should start with 62.5 micrograms (a quarter of the dose) every other day, increasing progressively over 19 days to reach the recommended dose of 250 micrograms given every other day. The patients can inject Extavia themselves once they have been trained. Extavia treatment should be stopped in patients whose condition does not improve.

For more information about using Extavia, see the package leaflet or contact your doctor or pharmacist.

The active substance in Extavia is the protein interferon beta-1b, one of a group of interferons that can be naturally produced by the body to help it fight against viruses and other attacks. In MS, the immune system (the body’s natural defences) malfunctions and attacks parts of the central nervous system (the brain, spinal cord and optic nerve [nerve that sends signals from the eye to the brain]), causing inflammation that damages the nerves and the insulation around them. The exact way that Extavia works in MS is not yet known but the active substance, interferon beta-1b, seems to calm down the immune system, and prevents relapses of MS.

Extavia was studied over a two-year period in 338 patients with relapsing remitting MS who were able to walk unaided, where its effectiveness was compared with placebo (a dummy treatment). Extavia was more effective than placebo in reducing the number of annual relapses: patients receiving the medicine had on average 0.84 relapses a year, when patients on placebo had 1.27 relapses.

Extavia has also been studied in 1,657 patients in two studies involving secondary progressive MS patients who were able to walk, where it was compared with placebo. One of the two studies showed a significant delay in the time to disability progression (31% risk reduction due to Extavia) and in the time to becoming wheelchair bound (39%). In the second study, no delay in the time to disability progression was seen. In both studies, Extavia showed a reduction in the number (30%) of clinical relapses.

In a study involving 487 patients with a single demyelinating event, treatment with Extavia for two years was shown to reduce the risk of developing clinically defined MS: 28% of the patients who received Extavia developed MS, compared with 45% of those who received placebo.

The most frequent side effects with Extavia are flu-like symptoms (including fever, chills, joint pain, malaise [feeling unwell], sweating, headache and muscle pain) and reactions at the site of injection. Side effects are common at the beginning of treatment but usually decrease with further treatment.

Extavia must not be used in patients who have severe depression or have thoughts of suicide. Extavia must not be used in patients who have decompensated liver disease (when the liver is damaged and can no longer work adequately).

For the full list of side effects and restrictions with Extavia, see the package leaflet.

The European Medicines Agency decided that Extavia’s benefits are greater than its risks and it can be authorised for use in the EU.

Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Extavia have been included in the summary of product characteristics and the package leaflet.

As for all medicines, data on the use of Extavia are continuously monitored. Side effects reported with Extavia are carefully evaluated and any necessary action taken to protect patients.

Extavia received a marketing authorisation valid throughout the EU on 20 May 2008.