Purpose Adherence to disease-modifying treatments is essential in order to maximize the beneficial effects of treatment for multiple sclerosis (MS). There are numerous treatments that have been approved. Treatment selection is essential in patient adherence. In addition, patient preference plays an increasingly significant role in treatment decision-making. This study aims to evaluate the degree of adherence, along with other variables that may influence this adherence, in Spain. Methods A cross-sectional study was conducted with 157 MS patients with disease-modifying treatments. Adherence was assessed using the Morisky Green scale, and other related factors were measured using a questionnaire that addressed demographics, disease characteristics, global perception of pathology, impact of medication on patient’s life, and treatment decision-making. Results The adherence rate was 71% and was associated with the following variables: older age, more treatments received, time to diagnosis 5–10 years, absence of exacerbations, better cognitive status, being married/in a union, clear information about the disease, and higher treatment satisfaction. The main cause for non-compliance was forgetfulness (27%). Conclusion The adherence rate is acceptable. It is widely known that treatment satisfaction is related to adherence. In our study, patients’ level of satisfaction was higher with oral treatments. However, oral administration showed a greater lack of adherence. The main cause of lack of adherence was forgetfulness. In relation to other variables, cognitive status and family support showed a correlation with treatment adherence.

Introduction: Hospital pharmacists are increasingly playing a critical role in the care of patients with multiple sclerosis (MS). However, little is known about their preferences and perspectives towards different attributes of disease-modifying therapies (DMTs). The objective of this research was to assess pharmacists´ preferences for DMT efficacy attributes. Methods: A multicenter, non-interventional, cross-sectional, web-based study was conducted. Preventing relapses, delaying disease progression, controlling radiological activity, and preserving health-related quality of life (HRQoL) and cognition were the attributes selected based on a literature review and a focus group with six hospital pharmacists. Conjoint analysis was used to determine preferences in eight hypothetical treatment scenarios, combining different levels of each attribute and ranking them from most to least preferred. Results: Sixty-five hospital pharmacists completed the study (mean age: 43.5 ± 7.8 years, 63.1% female, mean years of professional experience: 16.1 ± 7.4 years). Participants placed the greatest preference on delaying disease progression (35.7%) and preserving HRQoL (21.6%) and cognition (21.6%). Importance was consistent in all groups of pharmacists stratified according to demographic characteristics, experience, research background, and volume of patients seen per year. Conclusions: Understanding which treatment characteristics are meaningful to hospital pharmacists may help to enhance their synergistic role in the multidisciplinary management of patients with MS.

checkpoint. They have demonstrated their efficacy and safety in the treatment of different solid tumours. Purpose To evaluate the incidence of adverse events (AE) associated with immune checkpoint inhibitors and to analyse the management of the toxicity. Material and methods Descriptive and retrospective study which included every patient treated with Nivolumab or Pembrolizumab between April 2015 and September 2018 in a third-level hospital. Demographics and clinical variables were collected from the electronic medical records: sex, age, type of tumour, number of cycles, causes of treatment suspension, AE and its severity, as well the need for referral to other specialist, pharmacological treatment or hospitalisation for its handling. Results We included 71 patients (74.6% males), 60.6% were treated with Nivolumab and 39.4% with Pembrolizumab. Average age was 67.6 years (SD 10.3) and the median number of cycles was eight (1-70). The most frequent types of tumours were non-small-cell lung cancer (63.0%), bladder cancer (15.1%) and renal cancer (8.2%).74.7% of patients presented >1 AE, all immunomediated: 79.1% with Nivolumab (8.9% grade 3) and 71.4% with Pembrolizumab (22.5% grade 3). The most common AE in both groups were asthaenia (53.5% with Nivolumab and 32.1% with Pembrolizumab), skin toxicity (37.2% and 25% respectively) and diarrhoea (14% and 21.4% respectively). Immunemediated toxicity was the cause of permanent treatment suspension in 15.1% of patients (45.5% hepatitis and 18.2% pneumonitis).Referral to other specialists was necessary in 20.9% of patients treated with Nivolumab and 25% with Pembrolizumab. 32.6% of patients with Nivolumab and 39.3% with Pembrolizumab required pharmacological management. Also, 7% of cases required hospitalisation to control AE due to Nivolumab and 25% due to Pembrolizumab. Conclusion All treatment-related AE are immune-mediated. Despite being less frequent, there are certain AE which, due to their clinical relevance, led to the permanent suspension of treatment. The incidence of grade 3 EA was higher in patients treated with Pembrolizumab, as well as hospitalisation required. The role of a multidisciplinary team is essential in handling possible related EA, achieving an adequate treatment optimisation.