Nasal delivery of Rebif’s active ingredient interferon-beta, loaded in carbohydrate-based nanoparticles, reduced disease progression and nerve cell inflammation in a preclinical mouse model of multiple sclerosis (MS), a study demonstrated.
This alternate, non-invasive, low-cost treatment strategy has the potential to bypass the limitations of under-the-skin (subcutaneous) injections of Rebif and reduce the effective dose needed to achieve efficacy, the researchers said.
The study, “Intranasal delivery of interferon-β-loaded nanoparticles induces control of neuroinflammation in a preclinical model of multiple sclerosis: A promising simple, effective, non-invasive, and low-cost therapy,” was published in the Journal of Controlled Release.
Rebif, marketed by EMD Serono (known as Merck KGaA outside the U.S. and Canada), is an approved, first-line MS therapy that reduces inflammation in nerve cells (neurons) in the brain and spinal cord. It suppresses attacks on the myelin sheath, the protective coating surrounding neurons, easing disease symptoms.
However, many MS patients are unresponsive to Rebif or discontinue treatment due to adverse effects. Reduced efficacy is thought to be caused by its quick elimination from the body (short half-life) and limited access to the central nervous system (CNS), comprised of the brain and spinal cord, which is the therapy’s target tissue.
Regular infusions also can trigger injection-site reactions, including rash, swelling, and skin stiffness. Such side effects can cause discomfort, leading to poor adherence, treatment failure, and ultimately, to a worse long-term prognosis for MS patients. Further, continuous systemic exposure of high doses of the medication can prompt an immune response against the therapy, reducing its effectiveness.
Rebif’s direct delivery via the nasal cavity — intranasal, or through the nose — is a promising strategy to reach the CNS with less systemic side effects and more local control over inflammation. Moreover, this method is non-invasive and relatively easy to use.
Studies in healthy rats and non-human primates have shown that interferon-beta reaches the CNS following intranasal administration. However, the absorption of therapies applied through the nose is limited due to mucus clearance processes that decrease the therapy’s permanence time — how long it lasts — in the nasal cavity.
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