Patient adherence to and tolerability of self-administered interferon β-1a using an electronic autoinjection device: A multicentre, open-label, phase IV study

Alessandra Lugaresi, Ciro Florio, Vincenzo Brescia-Morra, Salvatore Cottone, Paolo Bellantonio, Marinella Clerico, Diego Centonze, Antonio Uccelli, Maria di Ioia, Giovanna De Luca, Andrea Marcellusi, Andrea Paolillo

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Achieving good adherence to self-injected treatments for multiple sclerosis can be difficult. Injection devices may help to overcome some of the injection-related barriers to adherence that can be experienced by patients. We sought to assess short-term adherence to, and tolerability of, interferon (IFN) β-1a administered via electronic autoinjection device in patients with relapsing-remitting multiple sclerosis (RRMS).Methods: BRIDGE (RebiSmart to self-inject Rebif serum-free formulation in a multidose cartridge) was a 12-week, multicentre, open-label, single-arm, observational, Phase IV study in which patients self-administered IFN β-1a (titrated to 44 μg), subcutaneously (sc), three times weekly, via electronic autoinjection device. Patients were assessed at baseline and 4-weekly intervals to Week 12 or early termination (ET) for: physical examinations; diary card completion (baseline, Weeks 4, 8 only); neurological examinations (baseline, Week 12/ET only); MS Treatment Concern Questionnaire (MSTCQ; Weeks 4, 8, 12 only); Convenience Questionnaire (Week 12 only); Hospital Anxiety and Depression Scale (HADS); and Paced Auditory Serial Addition Task (PASAT; baseline only). Adherence was defined as administration of ≥ 80% of scheduled injections, recorded by the autoinjection device.Results: Overall, 88.2% (105/119; intent-to-treat population) of patients were adherent; 67.2% (80/119) administered all scheduled injections. Medical reasons accounted for 35.6% (31/87) of missed injections, forgetfulness for 20.6% (18/87). Adherence did not correlate with baseline Expanded Disability Status Scale (P = 0.821) or PASAT (P = 0.952) scores, or pre-study therapy (P = 0.303). No significant changes (baseline-Week 12) in mean HADS depression (P = 0.482) or anxiety (P = 0.156) scores were observed. 'Overall convenience' was the most important reported benefit of the autoinjection device. Device features associated with handling and ease of use were highly rated. Mean MSTCQ scores for 'flu-like' symptoms (P = 0.022) and global side effects (P = 0.002) significantly improved from Week 4-12. Mean MSTCQ scores for pain at injection site and injection pain increased from Week 4-12 (P <0.001). Adverse events were mild/moderate. No new safety signals were identified.Conclusion: Convenience and ease of use of the autoinjection device may improve adherence and, therefore, outcomes, in patients with RRMS receiving sc IFN β-1a.Trial registration: EU Clinical Trials Register (EU-CTR; http://www.clinicaltrialsregister.eu): 2009-013333-24.

Original languageEnglish
Article number7
JournalBMC Neurology
Volume12
DOIs
Publication statusPublished - Mar 5 2012

Keywords

  • Drug delivery systems
  • IFN beta
  • Medication adherence
  • Relapsing-remitting multiple sclerosis
  • Self administration

ASJC Scopus subject areas

  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Patient adherence to and tolerability of self-administered interferon β-1a using an electronic autoinjection device: A multicentre, open-label, phase IV study'. Together they form a unique fingerprint.

Cite this