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复发型多发性硬化症中治疗性干扰素的互换可降低医疗保健和药房支出且安全性相当。

Therapeutic Interferon Interchange in Relapsing Multiple Sclerosis Lowers Health Care and Pharmacy Expenditures with Comparable Safety.

作者信息

Hahn Nicole, Palmer Kelsey E, Klocke Shilpa, Delate Thomas

机构信息

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 (

出版信息

Perm J. 2018 Aug 30;22:18-046. doi: 10.7812/TPP/18-046.

Abstract

INTRODUCTION

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

引言

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。

方法

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。

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。

结论

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。

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