An observational, retrospective, UK and Ireland audit of patient adherence to subcutaneous interferon beta-1a injections using the RebiSmart® injection device

Abstract

BackgroundPoor adherence to disease-modifying drugs is associated with an increased risk of relapse in patients with multiple sclerosis. However, adherence is difficult to assess objectively. RebiSmart® (Merck Serono SA, Geneva, Switzerland), a device for subcutaneous (sc) injection of interferon (IFN) β-1a, features an electronic injection log that can assist in objective monitoring of adherence.ObjectiveTo assess adherence to sc IFN β-1a injections using data from RebiSmart®.MethodsThis was a single-group, observational, retrospective audit. Adherence data were collected from patients with relapsing multiple sclerosis in the United Kingdom and Ireland who had been prescribed sc IFN β-1a and had been using RebiSmart® for a minimum of 24 months.ResultsIn total, 225 patients were included in the full analysis set; 72% were in the United Kingdom, and 28% were in Ireland. Overall, the mean age was 44.1 years, and 73% were women. Patients received sc IFN β-1a 44 µg (68%) or 22 µg (32%) three times per week. Mean adherence over the course of 24 months was 95.0% (median, 99.4%), and similar values were observed across all periods. The proportion of patients with 80% or higher adherence was 92.0% at 12 months and 91.1% at 24 months.ConclusionHigh adherence to sc IFN β-1a was observed across all patient groups using RebiSmart®, according to 2-year treatment adherence data. This may be partly attributed to the expert support patients received, supplemented by routine and regular contact from the MySupport patient-support program, as well as the self-motivation of patients who persisted with treatment for 2 or more years.

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

“…In contrast to our study, these studies were based on medical and pharmacy claims data, and adherent patients were defined as showing a medication possession ratio (MPR) ≥0.8 at observation periods of 12–36 months22 or 24 months,4 respectively. The MPR is a common method for measuring adherence based on dispensed medication, but it cannot verify that the medication has actually been used, and it may be prone to overestimation of adherence 17. In addition, the data analyzed in these studies4,22 originate from a time (between 2000 and 2009) when the IFN beta-Ia autoinjector device had not yet been available for the administration of sc IFN beta-1a.…”

“…Although slightly lower, the adherence rates observed in our study are in line with those seen in these three studies. The retrospective analysis by Willis et al17 of the IFN beta-Ia autoinjector device data from 225 patients in the UK and Ireland, who continued therapy for at least 2 years, yielded a mean adherence rate of 95% and showed that 91% of the patients were adherent (≥80% adherence) at month 24. A prospective observational study in 119 patients in Italy showed that after 12 weeks of treatment, 88% of the patients were adherent (≥80% adherence) 15.…”

“…To our knowledge, only three studies included analyses of treatment adherence in patients using the IFN beta-Ia autoinjector device system so far 15–18. Two studies were prospective observational studies conducted in various European countries;15,16 the third study was a retrospective audit of adherence data collected in daily practice in the UK and Ireland 17. The outcomes of these studies suggest that patients using the IFN beta-Ia autoinjector device are more adherent than those using traditional injection methods to administer DMDs.…”

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“…A number of smaller uncontrolled trials with follow-up periods between 12 weeks and 1.5 years revealed high adherence of ≥80%-90%. [21][22][23][24][25][26][27] Lugaresi et al 28,29 found a decrease in adherence (among completers) from 100% through week 4 to 99.1% in weeks 5-8, to 89.0% in weeks 9-12. After a long-term follow-up of 20.5 months, overall adherence was further decreased to 79.8%.…”

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].…”