Patient adherence to subcutaneous IFN beta-1a injections using the RebiSmart^® injection device: a retrospective real-world study among Dutch and German patients with multiple sclerosis

Abstract

PurposeLong-term treatment adherence among patients with multiple sclerosis (MS) is a general concern, with an established correlation with clinical efficacy. Closely monitoring patients’ treatment behavior may have a beneficial effect on adherence. This study assessed adherence, in daily life, to subcutaneous (sc) IFN beta-1a, self-administered using the RebiSmart® electronic injection device (the IFN beta-Ia autoinjector device), in patients with MS.Patients and methodsThis was a retrospective observational study analyzing treatment adherence based on injection data, eg, injection date and dose, extracted from the IFN beta-Ia autoinjector devices collected from patients in Germany and the Netherlands.ResultsData recorded in the period from 2007 to 2012 by the IFN beta-Ia autoinjector devices from 1,682 (79.7% from Germany, 20.3% from the Netherlands) patients were analyzed. A mean of 94.8% of the multi-dose cartridges (containing sc IFN beta-1a for three injections) were used completely, indicating a low incidence of application errors and drug wastage. The mean adherence rate was 90.7% and 82.9% over the entire observation period (mean treatment duration: 150.1 weeks). Median adherence rates were similar between German and Dutch patients (97.9% vs 99.0%).ConclusionIn daily clinical practice, patients using the IFN beta-Ia autoinjector device were highly adherent to sc IFN beta-1a. The injection data stored electronically in the device may help patients to adhere to treatment regimens and, if viewed by physicians, promote discussion of adherence issues with patients.

Using Patient Feedback to Optimize the Design of a Certolizumab Pegol Electromechanical Self-Injection Device: Insights from Human Factors Studies

“…RebiSmart ® (Merck, Zug, Switzerland) is an electronic injection device for use by multiple sclerosis patients. It was the first electromechanical autoinjector for multiple sclerosis patients [ 22 ], and has reported adherence rates of 95% across a median drug exposure period when the device is used for 979 days [ 23 – 25 ]. There is evidence suggesting that technologized injection devices may increase the rates of adherence to use of biologics.…”

Adherence to self-administering interferon-β1a using RebiSmart® device in Mexican patients with relapsing multiple sclerosis

“…Adherence to injectable DMTs and other interventional strategies is usually considered inferior in MS patients [10][11][12][13][14][15][16]; a retrospective study of MS patients initiating therapy with 1 of 4 injectable DMTs found that after 18 months, 11.2% of patients switched their medication, and 33.9% discontinued their treatment [17]. An adherence study on ambulatory patients carried out in Spain showed that after 2 years of starting DMT, INF-β was discontinued in 9.9% of patients, after 5 years discontinuation rose to 41.2% and after 8 years discontinuation rate was 58.7% [18].…”

“…Electronic auto-injection device (RebiSmart1; Merck Serono S.A.-Geneva, Switzerland, a branch of Merck Serono S.A., Coinsins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany) was developed for the subcutaneous administration of IFN-β1a [10][11][12][13][14]20]. The device simplifies the injection process and help patients to overcome injection-related issues, thereby possibly increasing adherence to treatment.…”

The Parker Model: Applying a Qualitative Three-Step Approach to Optimally Utilize Input from Stakeholders When Introducing New Device Technologies in the Management of Chronic Rheumatic Diseases

“…High levels of treatment adherence among multiple sclerosis patients have been reported in studies examining the use of electronic injection devices that are similar to the e-Device evaluated in the current study; for example, allowing patients to individually adjust settings, such as injection speed and depth, and having the ability to electronically store data such as date and time of injections [ 32 – 34 ]. Consistent with these studies in multiple sclerosis, patients with rheumatic diseases recruited to provide their input on the e-Device in the current study reported high levels of e-Device acceptability and high levels of empowerment in the heiQ, SUTAQ, and eHLQ questionnaire.…”