Lugaresi Alessandra
University Gabriele d'Annunzio of Chieti-Pescara, Ospedale Clinicizzato Santissima Annunziata, c/o Centro Sclerosi multipla (VII livello, corpo A), Department of Oncology and Neuroscience, Chieti, Italy.
Expert Opin Drug Deliv. 2009 Sep;6(9):995-1002. doi: 10.1517/17425240903134769.
Several injectable disease-modifying drugs are available for the treatment of multiple sclerosis (MS) to control disease progression and reduce relapse frequency and severity. However, the benefits offered by treatment may be compromised by suboptimal levels of adherence to prescribed regimens.
To examine what is now known about adherence to MS therapies, and to discuss how technological advances may affect adherence in the future, with reference to examples from other therapy areas.
Perceived lack of efficacy and therapy-related adverse events are important factors influencing poor adherence. Comprehensive patient education and support are vital in maintaining adherence to MS therapies. Also, improvements in the tolerability, convenience of administration and patient acceptability of MS therapies may enhance adherence. This may be achieved by adjustments to drug formulation and the use of injection devices. Auto-injector devices have been shown to reduce the incidence of injection-site reactions and discomfort in patients with MS, and it is hoped that improvements in delivery technology may further enhance patient motivation to remain adherent to MS therapy in the future. The most recent advance in injection-delivery technology is the development of electronic devices, which can be adjusted for comfort and record dosing history.
Few studies have directly addressed adherence to MS therapy and further clarification is required. Adjustments to drug formulation, provision of patient education and improvements to injection devices may all contribute indirectly to improved adherence in the future.
有几种可注射的疾病修正药物可用于治疗多发性硬化症（MS），以控制疾病进展并降低复发频率和严重程度。然而，治疗所带来的益处可能会因对规定治疗方案的依从性未达最佳水平而受到影响。
参考其他治疗领域的实例，研究目前已知的关于MS治疗依从性的情况，并讨论技术进步未来可能如何影响依从性。
认为缺乏疗效和与治疗相关的不良事件是影响依从性差的重要因素。全面的患者教育和支持对于维持MS治疗的依从性至关重要。此外，提高MS治疗的耐受性、给药便利性和患者可接受性可能会增强依从性。这可以通过调整药物剂型和使用注射装置来实现。自动注射器装置已被证明可降低MS患者注射部位反应和不适的发生率，并且希望给药技术的改进未来可能会进一步增强患者坚持MS治疗的动力。注射给药技术的最新进展是电子装置的开发，其可根据舒适度进行调整并记录给药历史。
很少有研究直接探讨MS治疗的依从性，需要进一步阐明。调整药物剂型、提供患者教育以及改进注射装置未来可能都间接有助于提高依从性。
