Hahn Nicole, Palmer Kelsey E, Klocke Shilpa, Delate Thomas
Clinical Pharmacy Specialist in Neurology for Kaiser Permanente Colorado, a Clinical Instructor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora and Clinical Affiliate Faculty at Regis University School of Pharmacy in Denver (
Clinical Pharmacy Specialist in the Anticoagulation and Anemia Service for Kaiser Permanente Colorado in Denver (
Perm J. 2018 Aug 30;22:18-046. doi: 10.7812/TPP/18-046.
For patients with a less-active (fewer relapses or complete recovery from relapses, less radiologic burden of disease, or no or limited disease-related disability) relapsing form of multiple sclerosis (MS), interferon (IFN) beta-1b subcutaneous is similar in efficacy to IFN beta-1a intramuscular and subcutaneous. The purpose of this study was to assess the impact of patient interchange from an IFN beta-1a to IFN beta-1b.
This was a retrospective, pre-post study of adult patients with relapsing MS who underwent interchange from an IFN beta-1a to IFN beta-1b between April 15, 2014, and April 30, 2015. Health care financial and utilization outcomes between the 6 months before and after interchange were compared, and safety outcomes after interchange were assessed.
A total of 36 primarily white, middle-age, and female patients underwent interchange. Monthly total health care and pharmacy expenditures decreased by approximately 40% and 44%, respectively, from pre-to-post interchange (p < 0.001). Health care utilization was unchanged (p < 0.05). Seven (43.8%) patients underwent interchange back to IFN beta-1a intramuscular. No patients underwent interchange back to IFN beta-1a subcutaneous. The most common adverse effect reported after interchange was injection-site reaction.
Health care expenditures decreased and adverse effects were limited among patients with MS who underwent an interchange from an IFN beta-1a to IFN beta-1b. These findings suggest that a therapeutic interchange between IFNs for patients with less-active MS disease is well tolerated. Further research is needed to determine the impact of such an interchange on disease progression.
对于复发型多发性硬化症（MS）病情活动度较低（复发次数较少或复发后完全恢复、疾病的影像学负担较轻、或无疾病相关残疾或残疾有限）的患者，皮下注射干扰素（IFN）β-1b与肌肉注射和皮下注射IFNβ-1a的疗效相似。本研究的目的是评估患者从IFNβ-1a转换为IFNβ-1b的影响。
这是一项回顾性的前后对照研究，研究对象为2014年4月15日至2015年4月30日期间从IFNβ-1a转换为IFNβ-1b的复发型MS成年患者。比较了转换前后6个月的医疗保健财务和使用结果，并评估了转换后的安全性结果。
共有36名主要为白人、中年女性患者进行了转换。转换前后，每月的医疗保健总支出和药房支出分别下降了约40%和44%（p<0.001）。医疗保健利用率没有变化（p<0.05）。7名（43.8%）患者又换回了肌肉注射IFNβ-1a。没有患者换回皮下注射IFNβ-1a。转换后报告的最常见不良反应是注射部位反应。
从IFNβ-1a转换为IFNβ-1b的MS患者医疗保健支出减少，不良反应有限。这些发现表明，病情活动度较低的MS患者在两种干扰素之间进行治疗转换耐受性良好。需要进一步研究以确定这种转换对疾病进展的影响。
