Factors leading patients to discontinue multiple sclerosis therapies.

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.