Factors leading patients to discontinue multiple sclerosis therapies.
OBJECTIVE
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.


METHODS
Cross-sectional study.


METHODS
University-based neurology clinic.


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


METHODS
Telephone survey.


METHODS
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.


CONCLUSIONS
Patient education on adverse effects and realistic patient expectations may be potential areas of study to improve discontinuation percentages with these agents.
Daugherty
Kimberly K
KK
University of Kentucky, Lexington, USA.
Butler
J S
JS
Mattingly
Michelle
M
Ryan
Melody
M
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D000068717:Glatiramer Acetate; D006801:Humans; D000068556:Interferon beta-1a; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy*; D010455:Peptides / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D017211:Treatment Failure; D016312:Treatment Refusal / Q000523:psychology*
D000276:Adjuvants, Immunologic; D010455:Peptides; D000068576:Interferon beta-1b; D000068717:Glatiramer Acetate; D016899:Interferon-beta; D000068556:Interferon beta-1a