Most patients with multiple sclerosis (MS) are satisfied with the conditions of their intravenous therapy (administered directly into the bloodstream) and are very aware of the therapy’s safety, according to a small Macedonian study.
Also, establishing a specialized infusion center would substantially increase intravenous treatment satisfaction and adherence.
The study, “Strategies to Enhance the Intravenous Treatment Satisfaction and Drug Safety Awareness Among Patients with Multiple Sclerosis in Macedonia,” was published in the journal Prilozi.
Many patients initially diagnosed with relapsing-remitting MS (RRMS) eventually will transition to secondary progressive MS (SPMS), in which there is a progressive worsening of nerve cell function and accumulation of disability over time.
Disease-modifying therapies (DMTs), designed to reduce the progression of MS from RRMS to SPMS, have shown promising results. Antibody-based DMTs – such as Ocrevus (ocrelizumab), Tysabri (natalizumab), and Lemtrada (alemtuzumab) – are a new class of therapies that use antibodies against molecules associated with the development or worsening of MS.
In many cases, these antibody-based therapies are prescribed after failure of one or more first-line therapies. They are administered directly into the bloodstream (intravenous infusion) in a hospital center with adequate resources.
Patients’ adherence to treatment is extremely important, as prevention or reduction of disease progression may depend on it. Treatment satisfaction and incidence of adverse events influence patients’ treatment adherence, which is essential to ensure patients obtain the best treatment outcomes and also to make the treatment cost-effective.
Researchers evaluated treatment satisfaction and therapy safety awareness in 13 MS patients (11 women and two men) on intravenous treatment at the University Clinic for Neurology in Skopje, Macedonia.
All participants answered a questionnaire containing 20 questions about their demographic characteristics, disease course, intravenous treatment satisfaction, and therapy safety awareness.
Patients’ mean age was 35 years, and the average age at MS diagnosis was 27.7 years. Seven (54%) had RRMS, while six (46%) had SPMS. The most common symptoms at disease onset were tingling (46%), numbness (31%), vision loss (23%) and muscle weakness (23%).
Patients received at least one DMT before switching to intravenous treatment, and this switch took place after an average of six years after diagnosis, mainly due to the occurrence of new disease relapses. At the time of the study, participants were receiving a monthly intravenous infusion (average duration of two hours) for an average of 18 months.
The researchers found that 70% of patients were satisfied with their intravenous treatment, while 23% were not satisfied and only 7% were very satisfied. Patients with RRMS reported being more satisfied than those with SPMS. However, the reasons behind this difference were not clarified.
The most common suggestions given from patients to potentially improve their satisfaction were the existence of a room uniquely dedicated to intravenous treatment in MS patients (47% of all suggestions), having better beds or specialized intravenous chairs (35% of all suggestions), and having heating/cooling system in the room (18% of all suggestions).
Regarding patients’ therapy safety awareness, all patients were informed by their neurologist and/or nurse conducting the intravenous therapy about possible treatment-associated adverse events before the treatment, which indicated good clinical practice and high awareness among MS patients.
“It is anticipated that new biological MS medications that require IV infusion will change the future outcomes of MS treatment,” researchers wrote.
“With careful planning and a review of existing resources … the establishment of a special MS infusion center might potentially enhance the overall IV treatment experience of MS patients, especially those with more severe forms of the disease,” they added.