Early interferon beta treatment in multiple sclerosis: nursing care implications of the BENEFIT study.
Interferon beta (IFNbeta) is a first-line treatment for relapsing forms of multiple sclerosis (MS) that can reduce the rate of clinical attacks and limit disability progression. Recent trials have shown that initiating IFNbeta treatment at the time of the first clinical event suggesting MS can delay the onset of clinically definite MS and, in the case of IFNbeta-1 b, inhibit the progression of later disability. These findings have led to a trend toward earlier treatment initiation in clinical practice. While trials show good levels of adherence to therapy, there often is room for improvement in the clinical setting. Managing MS symptoms and treatment-related adverse events and providing patient education are vital to optimize adherence, and nurses can employ a number of strategies as part of the support program to ensure patients gain the most benefit from their treatment. In addition to providing a great deal of evidence supporting early MS treatment, the ongoing BEtaseron in Newly Emerging multiple sclerosis For Initial Treatment (BENEFIT) study has highlighted the fact that IFNbeta can be well tolerated, especially with correct management. This article summarizes the lessons learned from the BENEFIT study, and the ways in which nurses can incorporate this knowledge into clinical practice.
Webb
Ute H
UH
Ottawa Hospital, Ottawa, Ontario, Canada. uhwebb@sympatico.ca
D000276:Adjuvants, Immunologic / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D002986:Clinical Trials as Topic; D018450:Disease Progression; D016903:Drug Monitoring; D055317:Evidence-Based Practice; D005500:Follow-Up Studies; D000068717:Glatiramer Acetate; D006801:Humans; D016899:Interferon-beta / Q000009:adverse effects / Q000627:therapeutic use*; D055118:Medication Adherence; D008942:Mitoxantrone / Q000627:therapeutic use; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000451:nursing* / Q000523:psychology; D000069442:Natalizumab; D024802:Nurse's Role; D009730:Nursing Assessment; D010353:Patient Education as Topic; D018579:Patient Selection; D010455:Peptides / Q000627:therapeutic use; D011788:Quality of Life; D012944:Social Support; D013997:Time Factors; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069442:Natalizumab; D010455:Peptides; D000068717:Glatiramer Acetate; D016899:Interferon-beta; D008942:Mitoxantrone