autoinjector

[lscmb0517]

Does anyone use the AJ instead of manually injecting? What have you found to be more tolerable.

I was on Avonex since 2/2000 and am considering switching to rebif or copaxone. I'm sick of that darn needle!!!!! My neuro says either is fine. I was scheduled to start Tysabri next friday...but well, we all know the story on that so I wont go into it. In the meantime...any suggestions

Thanks!!

[bebe]

I work with alot of patients on many different therapies and the opinion on use of autoinjectors differs across the board. Some people love the autoinjectors because they can give the injection themselves and dont have to see the needle. Others experience bruising with the autoinjectors and prefer just to manually inject. Rebif and Copaxone autoinjectors are very similair, however, Rebif syringes have 29g gauge needles, which are the thinnest and sharpest available. Alot of people have done really well since the needle became smaller. Regardless, you will love the difference between sub-q and IM, just keep in mind you may see more redness and swelling at injection site.

In terms of which to choose, do your homework. They are very different and have different effects on disease progression. Rebif has much better control over MRI lesion progression and is indicated for reducing progression of disability. Copaxone is indicated for reducing relapses only. Good luck.

[Houdini]

Rebif has much better control over MRI lesion progression and is indicated for reducing progression of disability. Copaxone is indicated for reducing relapses only.

Bebe,

I'm curious, on what basis do you make the above statement? I thought Copaxone and Rebif had similar track records in all three categories (lesion progression, relapse reduction and progression of disablility), especially in light of Copaxone's 10-year data.

I use the autoinjector with Copaxone and find that it is relatively painless. I am fortunate in that I rarely bruise and my site reactions are minimal. I have found that over a period of time, the stinging and site reactions became less prevalent, but I suspect this is a highly individual result.

One tip -- I have found that if I do the autoinect and then immediately jump in the shower (that's how I have arranged my morning routine), the stimulus of the shower counters the post-injection stinging sensation. It works for me.

[carolsue]

Hi lscmb!
after being on Avonex I imagine you'll laugh at the tiny little Rebif or Copaxone needles!

I've been on Rebif for 9 months, started with the older autoinjector and thicker needles. It used to be very painful for me. The new smaller needle and the new AJ are both MUCH more comfortable. I believe the pH was reformulated too, which has lessened the pain I used to have on injection. I manually inject the areas I can comfortably reach (abdomen, hips and thighs), and use the AJ for places that are harder to reach (buttocks, arms). I "bruise" equally with both methods. My bruises are reddish, and last for up to 6 weeks.

Tip: One problem I've noticed with the AJ is that if I remove the needle cap according to the instructions, more often than not, I get a drop of medicine on the needle. It's hard to wipe the needle dry as it's enveloped in the AJ. So now I remove the needle cap before loading the AJ, and I just take a lot of care that I don't touch the bare needle on anything when I'm loading it.

As for Rebif vs. Copaxone, I can't speak to efficacy but I do like the flexibility of the 3x per week of Rebif. Usually I do MWF, but sometimes (traveling, big day the next day, etc.) it makes more sense to do MWSat, or SunTF, or...you get the picture. Copaxone's every day, isn't it? Not much flexibility there.

finally, the first few months on Rebif I noticed the flu like symptoms after each dose, but these were manageable with ibuprofen. I don't get those symptoms any more. initially, and for about 6 months, my liver enzymes elevated and my platelets dropped. but now, after 9 months, all blood chemistry is normal.

hope this helps and good luck!
carolsue

[BeckyLA]

I've been on Rebif for a couple months now and I think I'm about used to the stuff. I had flu-like symptoms for the first month and a half, but It's slacked off. I tried the autoinject, but I like manual better because I can control how fast the meds are injected.

[stsolakos]

...

[lscmb0517]

Thank you to all who responded to my question. I think I'm leaning toward Rebif...because three times a week is better than everyday. I'm hoping the fact that I've been on Avonex for so long that I wont have to go through the "self-inflicted flu" I appreciate having a place like this to ask questions.

Take care
Christine

[SandyP]

I have been on Rebif since 10/04 (dx 09/04) and have been relatively symptom-free. I use the AJ and manually inject sometimes. I don't think it hurts so much when I manually inject, but the redness and bruising are worse. I have stopped using my thighs for now, as they look like I have been beaten up.

I have noticed stinging from the med when I have self injected around the belly.

I am just getting used (though I don't like it!) to doing the injections...the alternatives could be much worse.
Sandy

[bebe]

Rebif has much better control over MRI lesion progression and is indicated for reducing progression of disability. Copaxone is indicated for reducing relapses only.

Bebe,

I'm curious, on what basis do you make the above statement? I thought Copaxone and Rebif had similar track records in all three categories (lesion progression, relapse reduction and progression of disablility), especially in light of Copaxone's 10-year data.

I make that statement based on the indication per both drug's package insert. The indication from the FDA is based on original pivotal trials. Rebif is the only therapy that has shown a statistically significant benefit in all three areas in their piviotal trial (per AAN Guidelines on DMD therapy). Take a look at the Copaxone package insert.
In terms of their 10 year data- this is an extension of a 2 year study that didnt even meet statistical signifcance of its endpoint at 2 years. Then the study became open label. At this point, a large majority of patients discontinued the study and ones that stayed in were patients responding well to the trial. Therefore, this is not representative of the study group as a whole- just responders.

I use the autoinjector with Copaxone and find that it is relatively painless. I am fortunate in that I rarely bruise and my site reactions are minimal. I have found that over a period of time, the stinging and site reactions became less prevalent, but I suspect this is a highly individual result.

One tip -- I have found that if I do the autoinect and then immediately jump in the shower (that's how I have arranged my morning routine), the stimulus of the shower counters the post-injection stinging sensation. It works for me.

[Marknamealreadytaken]

I have been using the autoinjector for about 16 months. I think it is great. I was an avonnex addict for about 6 months. Big differrence. More injections w/rebif but its done so much more often then Avonex you don't really have the one week lag time to forget how great the last injection went. I tried to inject myself without the autoinjector for the first few times because it hadn't arrived yet. Had to pinch and lift up skin for the initial stab and being uncoordinated I had trouble releasing the skin and pushing the plunger.. That Hurt!! also had a little back flow out of the wound as well. Have always used the injector and always will.

[JFH]

... and always will.

Of course one day, Mark, we all hope we wont need to at all