Devonshire Virginia A, Feinstein Anthony, Moriarty Patrick
Department of Neurology, University of British Columbia, Vancouver, Canada.
Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
BMC Res Notes. 2016 Mar 8;9:148. doi: 10.1186/s13104-016-1948-z.
In a multicentre, single-arm, observational, phase IV study, we evaluated 24-week treatment adherence of relapsing multiple sclerosis (RMS) patients using an electronic auto-injection device (RebiSmart(®)) for subcutaneous injection of interferon (IFN) β-1a.
A total of 162 adult participants with RMS were enrolled into the study to use RebiSmart(®) to self-administer IFN β-1a 44 μg three times weekly for a maximum of 96 weeks. The number of administered injections was recorded in the electronic device log. Adherence to treatment was defined as the administration of ≥80% of expected injections. Cognitive impairment and injection anxiety were assessed via questionnaires.
Overall, 91.8 and 82.9% of participants were adherent to treatment at weeks 12 and 24, respectively. By weeks 12 and 24, 8.2 and 13.9% of participants had discontinued treatment. There were no statistically significant differences in adherence rates at weeks 12 and 24 according to cognitive impairment status or injection anxiety. By week 24, 69.9% of participants were less fearful of injection than when they started the study. According to participant evaluations, the absence of a visible needle, comfort settings, and the calendar for tracking the injection schedule were all important features of the RebiSmart(®) injection system. At week 24, 99.3% of participants reported that they would like to continue using RebiSmart(®) as their injector.
RebiSmart(®) use is associated with high treatment adherence, as objectively assessed using electronic injection logs. Future research should examine if RebiSmart(®) use improves long-term treatment outcomes in RMS. This study was registered with ClinicalTrials.gov as NCT01128075, on May 20, 2010.
在一项多中心、单臂、观察性IV期研究中,我们使用电子自动注射装置(RebiSmart(®))皮下注射干扰素(IFN)β-1a,评估复发型多发性硬化症(RMS)患者24周的治疗依从性。
共有162名成年RMS参与者纳入本研究,使用RebiSmart(®)自行皮下注射44μg IFNβ-1a,每周三次,最长96周。电子设备日志记录给药注射次数。治疗依从性定义为给药次数≥预期注射次数的80%。通过问卷评估认知障碍和注射焦虑。
总体而言,分别有91.8%和82.9%的参与者在第12周和第24周坚持治疗。到第12周和第24周时,分别有8.2%和13.9%的参与者停止治疗。根据认知障碍状态或注射焦虑情况,第12周和第24周的依从率无统计学显著差异。到第24周时,69.9%的参与者比开始研究时对注射的恐惧减轻。根据参与者评估,无可见针头、舒适设置以及注射日程跟踪日历都是RebiSmart(®)注射系统的重要特征。在第24周时,99.3%的参与者报告他们愿意继续使用RebiSmart(®)作为其注射器。
使用RebiSmart(®)与高治疗依从性相关,这是通过电子注射日志客观评估得出的。未来研究应考察使用RebiSmart(®)是否能改善RMS的长期治疗效果。本研究于2010年5月20日在ClinicalTrials.gov注册,注册号为NCT01128075。