Side Effects and Convenience of MS Therapies Seen to Determine Patients’ Adherence to Them

Despite the existence of several disease-modifying drugs for people with relapsing-remitting multiple sclerosis (RRMS), patients’ satisfaction plays a critical role in their adherence to treatment. Improving adherence should be a major concern in the clinic to prevent patients from evolving to more debilitating stages of the disease.

A team of researchers in Germany report that side effects and a therapy’s convenience are highly likely to determine adherence to treatment, and should be the focus of future approaches to increase regular use. The study, “Therapy satisfaction and adherence in patients with relapsing-remitting multiple sclerosis: the THEPA-MS survey,” was published in the journal Therapeutic Advances in Neurological Disorders.

If not treated, RRMS can progress into secondary progressive multiple sclerosis (SPMS), and increased disability. Currently, a number of disease-modifying drugs are available for RRMS patients, including interferon (IFN) β1a or β1b, glatiramer acetate (GA), azathioprine (AZA) or immunoglobulins (IGs).

These treatments can reduce the number of relapses and slow disease progression, thereby delaying worsening. However, studies have suggested that up to a third of patients discontinue their treatment, usually due to side effects or lack of efficacy. These observations strengthen the idea that patient’s preference should be taken into account in the choice of treatments to enhance their adherence to the prescribed MS therapy.

Consistently, researchers have found that satisfaction is determinant in the adherence and regular intake of prescribed drugs. A recent study reported in Multiple Sclerosis News Today also showed that both preference and satisfaction are greatly shaped by patients’ previous experiences with particular treatments.

The researchers assessed the satisfaction of MS patients with their current treatment in an open, prospective, multicenter, noninterventional study called “Therapy satisfaction in patients with relapsing-remitting multiple sclerosis” (THEPA-MS). They examined different satisfaction parameters in 3,312 people to identify predictors of treatment discontinuation.

Patients’ mean age was 43.7 years, 73.3% were women, and the mean level of disability was 2.29 as measured with the Expanded Disability Status Scale. At the time of documentation, 13.3% of the patients were not receiving any medication, 21.3% were using IFN β1a intramuscularly, 20.7% had IFN β1a subcutaneously, 17% had IFN β1b subcutaneously, 23.7% had GA, and only 1.1% and 0.2% had AZA and IG, respectively.

Analysis revealed that patients decided against a therapy due to fear of side effects, inconvenience, and a lack of trust in its efficacy. In fact, 40% of patients terminated therapy or missed an injection mainly due to side effects and problems at the injection site.

Patients’ satisfaction and treatment effectiveness were found to be associated with fewer relapses, lower disability scores, longer duration of the medication, and the absence of several side effects. This suggests that patients’ individual needs and concerns should be addressed, and that fewer side effects and treatment convenience should be areas of major focus to increase adherence levels.