Factors leading patients to discontinue multiple sclerosis therapies

J Am Pharm Assoc (2003). 2005 May-Jun;45(3):371-5. doi: 10.1331/1544345054003804.

Abstract

Objectives: To determine the percentages of patients who discontinued treatment with the multiple sclerosis medications intramuscular interferon beta-1a (IFN-beta-1a; Avonex-Biogen), interferon beta-1b (IFN-beta-1b; Betaseron-Berlex), and glatiramer acetate (Copaxone-Teva) and to determine the factors that led to discontinuation of the medications.

Design: Cross-sectional study.

Setting: University-based neurology clinic.

Patients: 108 patients with multiple sclerosis who were prescribed intramuscular interferon beta-1a, subcutaneous interferon beta-1b, or subcutaneous glatiramer acetate.

Intervention: Telephone survey.

Main outcome measures: Discontinuation percentages and the factors that contributed to discontinuation.

Results: There was no significant difference between the percentages of patients who discontinued and did not restart treatment with the products (interferon beta-1b, 41%; intramuscular interferon beta-1a, 34%; and glatiramer acetate, 28%). Four main reasons for medication discontinuation emerged: adverse effects (52%), physician-documented disease progression (40%), patient perception of drug ineffectiveness (20%), and cost (4%). No statistical differences were identified among the three agents for any of the reasons for discontinuation.

Conclusion: Patient education on adverse effects and realistic patient expectations may be potential areas of study to improve discontinuation percentages with these agents.

MeSH terms

  • Adjuvants, Immunologic / administration & dosage
  • Adjuvants, Immunologic / adverse effects*
  • Adjuvants, Immunologic / therapeutic use
  • Adult
  • Cross-Sectional Studies
  • Female
  • Glatiramer Acetate
  • Humans
  • Interferon beta-1a
  • Interferon beta-1b
  • Interferon-beta / administration & dosage
  • Interferon-beta / adverse effects*
  • Interferon-beta / therapeutic use
  • Male
  • Multiple Sclerosis / drug therapy*
  • Peptides / administration & dosage
  • Peptides / adverse effects*
  • Peptides / therapeutic use
  • Treatment Failure
  • Treatment Refusal / psychology*

Substances

  • Adjuvants, Immunologic
  • Peptides
  • Interferon beta-1b
  • Glatiramer Acetate
  • Interferon-beta
  • Interferon beta-1a