Factors that influence adherence with disease-modifying therapy in MS

Although injection-site reactions (ISRs) occur with US Food and Drug Administration-approved injectable disease-modifying therapies (DMTs) for multiple sclerosis, there are currently few reports of real-world data on ISR management strategies or possible correlations between ISRs and patient demographics, disease characteristics, and missed injections. Patient-reported data on the use of DMTs, patient demographic and disease characteristics, missed injections, and ISR reduction strategies were collected via e-mail, a patient registry (www.ms-cam.org), and a Web-based survey. Of the 1380 respondents, 1201 (87%) indicated that they had used injectable DMTs, of whom 377 (31%) had used intramuscular (IM) interferon beta-1a (IFNβ-1a), 172 (14%) had used subcutaneous (SC) IFNβ-1a, 183 (15%) had used SC IFNβ-1b, and 469 (39%) had used glatiramer acetate (GA). The majority of respondents were older (73% were ≥40 years), female (79%), married or living with a partner (72%), white (94%), and nonsmoking (82%). Injection-site reaction incidence, grouped according to severity, varied among DMTs, with IM IFNβ-1a causing significantly (P < .001) fewer mild, moderate, or severe ISRs than the other therapies. Female sex and younger age were significantly (P < .05) associated with more moderate ISRs among users of IM IFNβ-1a, SC IFNβ-1b, and GA. Nonwhites reported severe ISRs more often than whites. For all DMTs injection-site massage and avoidance of sensitive sites were the most frequently used strategies to minimize ISRs. These data may help identify patients with characteristics associated with a higher risk for ISRs, allowing health-care professionals to provide anticipatory guidance to patients at risk for decreased adherence or discontinuation. Int J MS Care. 2012;14:46-53.

Section: Discussionsupporting

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Section: Factors Associated With Injection-site Reactions In Msmentioning

confidence: 99%

See 1 more Smart Citation

Injectable Multiple Sclerosis Medications

Stewart¹,

Tran²

2012

“…A discus- 9 reported that adherent patients had a significantly shorter disease duration (P < .001) and a shorter duration of therapy (median, 6.0 years) than nonadherent patients. In a multicenter observational study of 78 patients, Treadaway et al 31 reported a higher adherence rate for MS patients with a disease duration of less than 3 years (P = .0185). In other reports, high EDSS score was considered a main factor predicting interruption of therapy.…”

Section: Discussionmentioning

confidence: 97%

Adherence to First-Line Disease-Modifying Therapy for Multiple Sclerosis in Kuwait

Alroughani

Thussu

2012

The aim of this retrospective study was to determine the rate of nonadherence to disease-modifying therapies (DMTs) among multiple sclerosis (MS) patients in Kuwait and to identify reasons for patient discontinuation of long-term therapy. Using a newly established MS registry at our institution, we collected data on MS patients' demographics, clinical characteristics, disability measures, and continuation or discontinuation of first-line DMTs. Reasons for nonadherence were divided into four categories: adverse events, inconvenience, perceived lack of efficacy, and physician-documented disease progression. Of 212 eligible patients, 40.1% were found to be nonadherent to first-line DMTs. In the nonadherent group, the female-to-male ratio was 1.75:1 and the mean age at disease onset was 26.8 years. Of this group, 69.4% of patients had a relapsing-remitting course, 18.8% had a secondary progressive course, and 11.8% had clinically isolated syndrome. Compared with the adherent group, the nonadherent group had a shorter mean disease duration (P = .014) and a greater likelihood of having Expanded Disability Status Scale (EDSS) scores of 3 or lower (67.1% vs. 48.0%; P = .007). Inconvenience was the most common reason for nonadherence (32.9%), followed by perceived lack of efficacy (25.9%), adverse events (23.5%), and physician-documented disease progression (17.7%). In summary, the rate of nonadherence to first-line DMTs in MS patients at our institution is considered high. Most nonadherent patients had a short disease duration and low EDSS scores. Inconvenience and perceived lack of efficacy were the most common reasons for nonadherence. The results demonstrate a need to improve treatment adherence among MS patients in Kuwait through providing better patient education, improving communication between patients and health-care providers, defining therapy expectations, and instituting new therapeutic techniques. Int J MS Care. 2012;14:17-24.

“…1,2 Reasons for poor patient adherence to prescribed MS therapies include frequency of administration and adverse events, such as flu-like symptoms (FLSs) and injection-site reactions (ISRs), associated with interferon beta treatments. [3][4][5][6][7][8] Peginterferon beta-1a is a pegylated form of interferon beta-1a approved for the treatment of relapsing forms of MS. The safety and efficacy of peginterferon beta-1a 125 μg administered subcutaneously every 2 or 4 weeks …”

mentioning

confidence: 99%

Management Strategies for Flu-Like Symptoms and Injection-Site Reactions Associated with Peginterferon Beta-1a

Halper

Centonze

Newsome

et al. 2016

A dherence to multiple sclerosis (MS) diseasemodifying therapies, such as interferons, has been linked to improved treatment outcomes and reduced health-care costs. 1,2 Reasons for poor patient adherence to prescribed MS therapies include frequency of administration and adverse events, such as flu-like symptoms (FLSs) and injection-site reactions (ISRs), associated with interferon beta treatments. [3][4][5][6][7][8] Peginterferon beta-1a is a pegylated form of interferon beta-1a approved for the treatment of relapsing forms of MS. The safety and efficacy of peginterferon beta-1a 125 μg administered subcutaneously every 2 or 4 weeks