Rebif vs. Tysabri for Multiple Sclerosis: Important Differences and Potential Risks.

Key takeaways

Rebif (interferon beta-1a) and Tysabri (natalizumab) are both used to treat relapsing forms of multiple sclerosis (MS), but they have some key differences. Rebif is an injectable biologic that you administer under the skin three times a week, while Tysabri is given as an IV infusion once a month by a healthcare provider. Rebif can cause flu-like symptoms and injection site reactions, whereas Tysabri can lead to serious infections and liver problems. Tysabri also requires enrollment in the TOUCH Prescribing Program due to its risk of a severe brain infection called progressive multifocal leukoencephalopathy (PML). Additionally, both Rebif and Tysabri are available only as a brand-name medication. Rebif has been around longer and has more research backing its use. Both medications can affect your immune system, but Tysabri's side effects are generally more severe and require closer monitoring.

Rebif

(interferon beta-1a)

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Tysabri

(natalizumab)

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Summary for Rebif

Prescription only

Rebif (interferon beta-1a) is an injectable biologic used for the treatment of relapsing multiple sclerosis (MS). However, it can cause uncomfortable flu-like symptoms as a side effect.

Indications for Rebif

Relapsing forms of multiple sclerosis (MS)

Pros and Cons for Rebif

Pros

A disease-modifying therapy (DMT) that prevents worsening MS
One of the first DMTs approved for MS, so theres a lot of research and experience
Comes as an autoinjector pen and prefilled syringe for easy at-home injections
Can be stored at room temperature for up to 30 days

Cons

Needs to be injected 3 times a week (more often than alternative medications like Avonex)
Not a first-choice treatment option for relapsing MS
Has many unpleasant side effects
Might not be a good option for people with a history of mental health conditions

Common Side Effects for Rebif

Injection-site reaction (89%)
Headache (65%)
Flu-like symptoms (56%)
Fatigue (33%)
Fever (25%)
Muscle pain (25%)
Stomach pain (22%)

Warnings for Rebif

Mental health
Liver damage
Injection site reactions and infections
Lower blood cell counts
Seizures

Summary for Tysabri

Prescription only

Tysabri (natalizumab) is an injectable medication used to treat relapsing forms of multiple sclerosis (MS) in adults. It can also treat moderate-to-severe Crohn's disease (CD) in adults. It works as an integrin antagonist to help lower inflammation in the body. Tysabri (natalizumab) is given by a healthcare professional as an infusion into a vein once a month. Common side effects include headache and fatigue. Because it has a risk of serious infections, you must enroll in the Tysabri TOUCH Program before starting treatment.

Indications for Tysabri

Relapsing forms of multiple sclerosis (MS)
Moderate-to-severe Crohn's disease (CD) when other treatments haven't worked well

Pros and Cons for Tysabri

Pros

Infusions are once every month
Can help reduce relapses in MS
An option for Crohn's disease when other treatments haven't worked well

Cons

Must be given by a healthcare professional in a healthcare setting
Raises your risk of serious infection
Only FDA approved for adults

Common Side Effects for Tysabri

Headache (38%)
Fatigue or feeling very tired (27%)
Urinary tract infection (21%)
Joint pain (19%)
Depression (19%)
Lower respiratory tract infection (17%)
Pain in arm or leg (16%)
Rash or other skin irritation (up to 12%)
Stomach discomfort (11%)
Diarrhea (10%)

Warnings for Tysabri

Risk of a brain infection leading to progressive multifocal leukoencephalopathy (PML)
Risk of other infections
Liver problems
Allergic reaction or infusion reaction
Low platelet levels
Other lab changes