MS Speaks
Multiple Sclerosis => MS - RESEARCH AND NEWS => Topic started by: agate on July 18, 2016, 09:20:10 pm
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Since it is often hard to tell whether an MS drug is working for an individual MS patient, it's not very surprising that people with MS choose whether to stay on a particular drug according to whether it is convenient and/or its side effects.
After all, since we are told not to expect a significant change in the way we feel if we take an MS drug, and the only way to find out if that drug is working for us is whether we have relapses less often than we did and how our MRIs compare with our earlier MRIs, why shouldn't we choose a drug based on its side effects and its convenience?
From Multiple Sclerosis News Today, July 13, 2016:
Side Effects and Convenience of MS Therapies Seen to Determine Patients’ Adherence to Them
Ines Martins, PhD
MS therapy and patient adherence
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 patients' preferences 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.
Azathioprine (Imuran, an immunosuppressant) is apparently not available for MS in the US but seems to be used in other countries.