RebiSmart Device Seen to Improve Adherence to Therapy in RRMS Patients
People with relapsing multiple sclerosis who use a device called RebiSmart (Merck Serono) to self-inject medications like Rebif (interferon [IFN] beta-1a) are more likely to take their therapies on a regular schedule and adhere to that schedule, resulting in fewer relapses than those not using the device, according to a retrospective study by researchers in Spain.
The report, “Long-Term Adherence to IFN Beta-1a Treatment when Using RebiSmart Device in Patients with Relapsing-Remitting Multiple Sclerosis,“ appeared Aug. 15, in the journal PLoS One.
Self-administration devices such as RebiSmart can both improve adherence to medication and increase patient satisfaction with treatment. In the 12-week BRIDGE study, adherence using  Rebismart was 88.2%, considered to be a high rate.
Adherence rates are important because the effectiveness of Rebif depends on its consistent use.
The current study included 258 patients with RRMS from 29 hospitals across Spain. Participants took Rebif using the RebiSmart device. Most were women (67.8%) and Caucasian (98.8%), with an average age of 40.7. A clear majority of these patients (81.8%) were using Rebif as a first MS treatment, and had been administering it using the RebiSmart device for 3.1 years.
Measures of adherence to treatment from the start to  whenever the device needed to be replaced or when treatment was discontinued was the study’s primary goal.
Investigators assessed the device’s use over three years, and found, overall, that adherence was 92.6%. A total of 78 participants (30.2%) had a 100% adherence rate, and 208 (80.6%) had an adherence rate of at least 90%. Only 34 patients (13.2%) had an adherence rate of less than 80%, and adverse events like relapses, fatigue or pain were the reasons most cited for stopping use.
“Suboptimal adherence was about 3 times higher in subjects who had suffered relapses than in those who had not,” the authors wrote. “Furthermore, 58.9% of the subjects did not experience any relapse since the beginning of the treatment, thus corroborating its effectiveness in reducing the incidence of relapses.”
Adherent patients also “showed a significant better quality of life, fewer neuropsychological issues, shorter duration of disease, and shorter duration of therapy than non-adherent patients,” the researchers reported.
Another advantage of the RebiSmart device is that it records its use, providing feedback to the user regarding how consistently they take their medication, the researchers said, noting this can aid in adherence, because “…electronic injection devices such as RebiSmart permit adherence to be recorded and monitored by the device itself, thereby improving comfort, subject satisfaction, and the adherence to the treatment of patients in this chronic disease.”
RebiSmart was first launched in the United Kingdom. The device has been approved in the European Union and Canada, but so far, it is not available in the U.S.
