Long-term interferon-β treatment for multiple sclerosis

Abstract

The aim of our study was to analyze the dropout rate in patients with relapsing-remitting multiple sclerosis (RRMS) under long-term treatment with the three commercially available interferon beta (IFNbeta) preparations. According to the drug taken, we divided 122 RRMS patients into 4 groups: Betaferon group, 56 patients taking INFbeta-1b (24 MIU weekly, subcutaneous injections); Avonex group, 38 patients taking IFNbeta-1a (6 MIU weekly, intramuscularly); Rebif group, 18 patients taking INFbeta-1b (18 MIU subcutaneously). Ten patients who shifted from Betaferon to Avonex were included in a fourth group. Dropouts were registered every trimester with the related cause. Data were evaluated using Kaplan-Meier survival analysis and log-rank test. During the observation period of five years, 48 patients (39.9%) dropped out: 48% of the patients in Betaferon group withdrew at a median of 758 days, 26% of the Avonex group at 356 days; 38% of the Rebif group at 421 days, and 40% of those who shifted from Betaferon to Avonex at 259 days. The differences between groups were not significant on survival analysis. Patients receiving higher dose treatment (Betaferon and Rebif groups) dropped out mainly for clinical adverse events; conversely, patients receiving lower dose therapy (Avonex group) dropped out most often for inefficacy. Patients who shifted to a lower dose treatment (fourth group) had a dropout rate similar to that of the initial treatment. Our data showed that one-third of the patients stopped the therapy, mostly for adverse events and then for inefficacy, while the remaining two-thirds were still on treatment without problems up to 5 years of follow-up. Compliance seems related to the dose of the drug, but further analysis is needed to confirm our data.

Review: Optimizing Adherence to Multiple Sclerosis Therapies

“…93 Treatment discontinuation of IFNβ therapies, regardless of cause, has been reported to be as high as 39.3% over 5 years in an observational study and 33.3% in a 6-year retrospective chart review. 93,94 Similar rates of discontinuation of glatiramer acetate for any reason have been reported. 95 No statistically significant differences have been found in the proportion of patients who discontinued treatment for any reason among IFNβ agents and glatiramer acetate.…”

Predictors of first-line treatment persistence in a Portuguese cohort of relapsing-remitting multiple sclerosis

“…The discontinuation rate due to adverse events is variable among the available studies, with rates reported ranging from 14.7% to 58% [5][6][7]10,14]. In our population the discontinuation rate due to adverse events was relatively low (27.18%).…”

“…In the pivot clinical trials of this drugs, the rates of DMT persistence at the end of first year ranged from 90% to 97% [1][2][3][4]. However, these results may not be adequately extrapolated to the real world population, as lower rates of treatment persistence have been reported in post-marketing studies, with real-world studies describing rates of treatment persistence from 78.5% to 90% after one year and dropping to 59% to 72% between the third and fifth year of treatment, with discontinuation occurring mainly due to side effects and lack of efficacy [5][6][7][8].…”

Nurses’ Perspective on Approaches to Limit Flu-Like Symptoms During Interferon Therapy for Multiple Sclerosis

“…8,9 However, these medications may have downstream effects that include aching muscles, fever, and a host of other systemic post-injection reactions, often referred to as flu-like symptoms (FLS). 10,11 Adherence to therapy is increasingly recognized as critical to improving long-term outcomes in MS patients, yet long-term adherence rates for MS treatment rarely exceed 75%. 12 While convenience-related factors, such as dosing frequency, can affect adherence, 13 tolerability issues also represent an important potential barrier to adherence.…”