RebiSmart Usage Among Young, Less Disabled MS Patients May Improve with More Knowledge, Study Suggests

Relapsing-remitting multiple sclerosis (RRMS) patients accurately report the use of the RebiSmart autoinjector to their neurologists, a questionnaire-based study has found.

The Phase 4 noninterventional CORE study also suggests that being knowledgeable about RebiSmart is a key factor in improving usage in younger patients and those with lower disability levels.

The results, including questionnaires from 56 patients, were reported in a study, “Subjective patient-reported versus objective adherence to subcutaneous interferon β-1a in multiple sclerosis using RebiSmart: the CORE study,” that appeared in the journal BMC Neurology.

The more an MS patient adheres to therapy, the more it may reduce the risk of relapse, disease progression and hospitalization. Adherence also improves quality of life while reducing MS-related medical costs.

Merck’s RebiSmart device is an electronic, multidose autoinjector for subcutaneous self-injection of interferon (IFN) β-1a, which is known to reduce relapses. An electronic log-file system objectively monitors patients’ adherence to RebiSmart — which is crucial when deciding on alternative treatments for patients who stop taking RebiSmart.

In the Phase 4 CORE study, researchers at 11 sites in Switzerland compared RebiSmart’s recorded dosing history with adherence reported by patients to their neurologists. They found that patients accurately reported adherence to RebiSmart even during a median treatment duration of two years.

Researchers found that the high-adherence group included older patients (53 years vs. 41 years in the low adherence group) and with a greater expanded disability status scale (3 versus 1.5).

“We hypothesize that older patients may have an increased awareness of the importance of treatment adherence for the prevention of further neurological disturbances,” authors stated. “This may also be true for patients with greater disability in our study, despite the potential difficulties in performing self-injections in individuals with reduced physical capacity.”

A higher adherence to RebiSmart in the CORE study also correlated with patients being well-informed about the device’s ease of use and technical features.

Yet the study also points to the importance of receiving information about this medication. In particular, it may improve MS treatment in younger and less disabled individuals who are less likely to use the device as directed.

Adherence rates from the CORE study are reflected in other European trials such as the SMART study of 912 RRMS patients, where mean objective adherence was reported to be 97.1 percent.

A long-term study in Spain of 110 MS patients found a median adherence of 96.5 percent over 2.7 years, and a smaller study in Finland reported a 93.5 percent object adherence rate in 29 patients followed up for 24 weeks.