
Multiple Sclerosis (MS) Support Group
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My Raynaud's has been something fierce the last few months...which I didn't understand because it was still warm temperatures. I found this article about a someone who was taking Rebif and it caused her Raynaud's to be severe. I have only been taking Rebif since the end of July so wondering if there is a connection. I am going to speak with my Dr. A few days ago, I was DX with possible SPMS instead of RRMS. Wondering if I even need Rebif then.
I know there are a few with Raynaud's out there. Any thoughts would be appreciated.
Here's the article:
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=10920422&dopt=AbstractPlus
[Severe Raynaud's phenomenon associated with interferon-beta therapy for multiple sclerosis: case report]
[Article in Portuguese]
Cruz BA, Queiroz ED, Nunes SV, Cruz Filho A, Campos GB, Monteiro EL, Crivellari H.
Faculdade de Medicina, Universidade Federal de Minas Gerais. borisc@net.cm.com.br
Interferon-beta (IFN-beta) is administered for treatment of multiple sclerosis (MS). We report on a woman with MS who presented with severe Raynaud's phenomenon, livedo-reticularis and digital necrosis two weeks after beginning therapy with IFN-beta. Symptoms improved after the IFN-beta was discontinued and anticoagulation associated with cyclophosphamide and corticoid were introduced. Raynaud's phenomenon is probably a side effect of IFN-beta therapy for multiple sclerosis.
PMID: 10920422 [PubMed - indexed for MEDLINE]
I know there are a few with Raynaud's out there. Any thoughts would be appreciated.
Here's the article:
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=10920422&dopt=AbstractPlus
[Severe Raynaud's phenomenon associated with interferon-beta therapy for multiple sclerosis: case report]
[Article in Portuguese]
Cruz BA, Queiroz ED, Nunes SV, Cruz Filho A, Campos GB, Monteiro EL, Crivellari H.
Faculdade de Medicina, Universidade Federal de Minas Gerais. borisc@net.cm.com.br
Interferon-beta (IFN-beta) is administered for treatment of multiple sclerosis (MS). We report on a woman with MS who presented with severe Raynaud's phenomenon, livedo-reticularis and digital necrosis two weeks after beginning therapy with IFN-beta. Symptoms improved after the IFN-beta was discontinued and anticoagulation associated with cyclophosphamide and corticoid were introduced. Raynaud's phenomenon is probably a side effect of IFN-beta therapy for multiple sclerosis.
PMID: 10920422 [PubMed - indexed for MEDLINE]
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Side Effects Associated with Interferon Beta Treatment
Treatment with IFN beta usually is well tolerated. Side effects depend partially on the dosage used and the route of administration. For all preparations mentioned, patients can experience flu-like reactions such as fever, myalgia, chills, and general discomfort for 24 to 48 hours after each injection, especially during the first months of treatment. These symptoms, however, generally are mild to moderate in severity and tend to decrease over time. Symptom management requires simple practical techniques such as dose escalation (some experts advocate giving a low dose of prednisone during the early weeks of initiating this agent), bedtime dosing, and the use of acetaminophen (paracetamol in Europe) or ibuprofen. The frequency of injection-site reactions (redness, tenderness, and swelling) is also initially high, almost exclusively in those patients who receive treatment by subcutaneous injection. Reactions can be managed by improving injection technique (e.g., warming the solution to room temperature, icing the injection site after each injection, and avoiding intradermal injections and excessive sun exposure) and maintaining site rotation. Injection-site necrosis occurs in about 5 percent of patients. In earlier studies, there was a suggestion that treatment with IFN beta could lead to depression or suicide attempts, but this was not supported by subsequent studies. Some people with MS report an initial worsening of symptoms during the first weeks of IFN therapy; an increase in spasticity has been reported in patients with primary and secondary progressive disease. IFN beta can also cause elevations in liver function tests, lymphopenia, or anemia. Some reports address the potential for severe autoimmune disease (thyroiditis, Graves disease, and hypothyroidism) after administration of IFN beta. Blood count and liver function are generally measured at baseline, then monthly for 3 months, and then every 3 months thereafter. The dose or frequency of administration in patients with elevated liver enzymes or neutropenia (rarely anemia) is reduced, but treatment is usually not discontinued. There are isolated reports that IFN beta administration may be followed by myasthenia gravis, rheumatoid arthritis, systemic lupus erythematous, inflammatory arthritis, urticaria, *****Raynauds phenomenon*****,
worsening of psoriasis, anaphylaxis, and intracerebral hemorrhage, but the association with IFN treatment often is unclear. Overall, the percentage of patients discontinuing treatment because of serious or intolerable side effects is low is low.
Here is what Raynaud's is:
http://en.wikipedia.org/wiki/Raynaud's_disease
The symptoms include several cyclic color changes:
1. When exposed to cold temperatures, the blood supply to the fingertips, toes, nose, and earlobes of Raynaud's disease patients is reduced and the skin turns pale or white (called pallor) and becomes cold and numb.
2. When the oxygen supply is depleted, the skin colour turns blue (called cyanosis).
3. These events are episodic and when the episode subsides, or the area is warmed, blood returns to the area and the skin colour turns red (rubor) and then back to normal, often accompanied by swelling and tingling. These symptoms are thought to be due to reactive hyperemias of the areas deprived of blood flow.
All three colour changes are present in classic Raynaud's disease. However, some patients do not see all of the colour changes in all outbreaks of this condition.