REBISTART: Adherence of Patients with Multiple Sclerosis to Treatment with Subcutaneous Interferon Beta in the Context of a Patient Support Program

Matthias Schwab; Andrew Chan; Anna-Katharina Eser; Boris Kallmann; Dieter Pöhlau; Joachim Richter; Torsten B Wagner; Christoph Grothe

doi:10.1007/s40120-024-00593-x

REBISTART: Adherence of Patients with Multiple Sclerosis to Treatment with Subcutaneous Interferon Beta in the Context of a Patient Support Program

Neurol Ther. 2024 Mar 26. doi: 10.1007/s40120-024-00593-x. Online ahead of print.

Authors

Matthias Schwab¹, Andrew Chan², Anna-Katharina Eser³, Boris Kallmann⁴, Dieter Pöhlau⁵, Joachim Richter⁶, Torsten B Wagner⁷, Christoph Grothe⁸

Affiliations

¹ Department of Neurology, Jena University Hospital, 07740, Jena, Germany. Matthias.Schwab@med.uni-jena.de.
² Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
³ Neurologisches Zentrum, Bezirksklinikum Mainkofen, 94469, Mainkofen, Germany.
⁴ Kallmann Neurologie, Luitpoldstraße 36, 96052, Bamberg, Germany.
⁵ DRK Kamillus Klinik, Hospitalstraße 6, 53567, Asbach, Germany.
⁶ Merck Healthcare Germany GmbH, Waldstraße 3, 64331, Weiterstadt, Germany.
⁷ Merck Healthcare Germany GmbH, Waldstraße 3, 64331, Weiterstadt, Germany. torsten.b.wagner@merckgroup.com.
⁸ GFO-Kliniken Troisdorf, 53844, Troisdorf, Germany.

PMID: 38530606
DOI: 10.1007/s40120-024-00593-x

Abstract

Introduction: Treatment adherence is a critical success factor in the disease-modifying therapy (DMT) of multiple sclerosis (MS). The REBISTART study prospectively evaluated adherence in patients using components of a patient support program (PSP).

Methods: The 12-month non-interventional multicenter study examined the real-world adherence to subcutaneously (sc) injected interferon beta-1a (Rebif^®). Patient-assessed adherence was measured by a visual analog scale (VAS) and the Morisky Medication Adherence Scale (MMAS). Objective adherence data were obtained by readouts from the RebiSmart^® injection device.

Results: Of 333 patients, 70.9% used the nursing service as the core component of the PSP. Self-assessed VAS-based adherence was stable over time at 94.0-96.3%. Similarly, MMAS score (maximum 4) was 3.8-3.9 at all visits, also reflecting high self-assessed adherence. In 269 patients using the RebiSmart^® injection device, mean readout-based objective adherence was similarly high (93.0-98.4% throughout visits). At last available visit, VAS-based adherence was independent of participation in the PSP nursing service (93.1% with participation versus 91.7% without it). Adherence was also independent of injection method or disease-related measures, including fatigue, depression, cognition, and quality of life. The most frequent reason for the premature discontinuations (38.7% of patients) was "change of treatment" (10.0%).

Discussion: We suggest that subgroups that may specifically benefit from PSP include patients who live alone, use multiple comedications, and are affected by cognitive impairment, depression, and/or fatigue. Further studies should investigate the potential usefulness of PSPs in these populations.

Conclusions: Very high adherence rates independent of the PSP nursing service over 1 year of treatment indicate that IFN beta-1a sc is an easy-to-use and well-tolerated disease-modifying drug.

Trial registration number: Vfa.de: No. 892. https://www.vfa.de/de/arzneimittel-forschung/datenbanken-zu-arzneimitteln/nisdb/nis-details/_892 .

Keywords: Adherence; Interferon beta-1a sc; Multiple sclerosis; Patient support program; Subcutaneous injection.