Immunomodulating drugs in Multiple Sclerosis: Compliance, satisfaction and adverse effects - evaluation in a German MS-population

Objective: Assessment of compliance, satisfaction and adverse effects in a German Multiple sclerosis (MS) population treated with immunomodulating drugs. Methods: A standardised, anonymous questionnaire was sent to the 1985 members with MS of the Berlin section of the German Multiple Sclerosis Association. Patients were questioned in regards to sociodemographic data, MS related topics, therapy, adverse effects and compliance. The response rate was 51.1%, from which 681 patients experienced in therapy with beta-Interferon 1a or 1b or Glatirameracetate were selected. Results: Most participants were treated with beta-Interferons, only one-third with Glatirameracetate. Patients with secondary progressive MS (SPMS) showed lesser satisfaction concerning their medication. About 75.5% of patients had used the medication longer than 2 years, especially those with a relapsing-remitting course (RRMS). Around one-third of all participants had their immunomodulating drug changed, mostly only once. The main reasons for discontinuation of the therapy were adverse effects, physician recommendation and treatment failures. Mood-related adverse effects (e.g. depression), fever and pain were perceived as most disturbing. Regression analysis revealed that dependence on a wheelchair and a secondary progressive course predicted a low compliance to treatment. Conclusion: Treating MS is a challenge. Cure is not possible, yet disease-modifying drugs are opportunities to positively influence the course of the disease if administered in a constant manner. To achieve such, the compliance must be reassured through adequate information about MS, therapeutic options, handling of medication, side effects and their management. Additionally, realistic therapeutic aims should be discussed with the patients.