Patti Francesco
Department of Neurology, University of Catania, Catania, Italy.
Patient Prefer Adherence. 2010 Feb 4;4:1-9. doi: 10.2147/ppa.s8230.
Poor treatment adherence is problematic in many therapy areas, including multiple sclerosis (MS). Several immunomodulatory drugs are available for the treatment of MS, all of which require frequent parenteral administration. Current first-line therapies are two formulations of interferon (IFN) beta-1a, one of IFN beta-1b, and one of glatiramer acetate. Discontinuation of treatment is common, particularly in the first few months after initiation. Although the true effect of poor adherence to MS therapy is not known, it is likely to lead to a fall in treatment efficacy. Many factors influence a patient's adherence to treatment, including the patient's MS subtype and disability level, cognitive impairment resulting from MS, perceived lack of efficacy of the prescribed medication, and adverse events associated with MS therapy. This article summarizes the barriers to adherence to MS therapies, and discusses patient management strategies that can be employed to encourage adherence. Future advances in the field of MS treatment will be explored, including the development of orally administered drugs, which may enhance adherence.
在包括多发性硬化症（MS）在内的许多治疗领域，治疗依从性差都是一个问题。有几种免疫调节药物可用于治疗MS，所有这些药物都需要频繁进行肠胃外给药。目前的一线治疗药物是两种剂型的干扰素（IFN）β-1a、一种IFNβ-1b和一种醋酸格拉替雷。停止治疗的情况很常见，尤其是在开始治疗后的头几个月。虽然MS治疗依从性差的真正影响尚不清楚，但很可能会导致治疗效果下降。许多因素会影响患者对治疗的依从性，包括患者的MS亚型和残疾程度、MS导致的认知障碍、认为所开药物缺乏疗效以及与MS治疗相关的不良事件。本文总结了MS治疗依从性的障碍，并讨论了可用于鼓励依从性的患者管理策略。还将探讨MS治疗领域未来的进展，包括口服药物的开发，这可能会提高依从性。
