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DD-011 Patient compliance with biological drugs: effectiveness of drug switching in multiple sclerosis
  1. L Fantini1,
  2. F Ambrosini Spinella2,
  3. C Polidori3,
  4. G Roatti1,
  5. A Resta2,
  6. F Uguccioni4,
  7. P Servici5,
  8. C Vitali2
  1. 1Istituto Ortopedico Rizzoli, Farmacia Ospedaliera, Bologna, Italy
  2. 2Area Vasta 1 ASUR Marche, Area Farmaco E PMC – Servizio Farmaceutico, Fano, Italy
  3. 3Università Di Camerino, Direttore Della Scuola Di Specializzazione in Farmacia Ospedaliera, Camerino, Italy
  4. 4Area Vasta 1 ASUR Marche, Servizio Farmaceutico, Urbino, Italy
  5. 5Area Vasta 1 ASUR Marche, Area Farmaco E PMC – Servizio Farmaceutico, Fossombrone, Italy


Background Multiple sclerosis develops differently in different patients (P), demands personalised drug treatment and is difficult to manage. Biological drugs (BD) may reduce symptoms and modify the progression of the disease.

Purpose We sought to measure P compliance when prescribed BDs, and to evaluate whether switching drugs could increase their compliance.

Material and methods Patients were interviewed in the period from January to April 2014.


24 P with INTERFERON BETA1a (9 Avonex, 15 Rebif)

6 P with INTERFERON BETA1b (4 Betaferon, 2 Extavia)

14 P with GLATIRAMER (Copaxone)

2 P with FINGOLIMOD (Gilenya).

Results Only 9 P expressed dissatisfaction with the treatments listed above.

5 of the patients complained of adverse drug reactions, 3 objected to the number of administrations and 1 lamented the poor efficacy.


The side effects of AVONEX and BETAFERON were well tolerated with 1 dissatisfied patient.

The side effects of REBIF and EXATVIA were less tolerable with 5 patients reporting flu-like symptoms (in accordance with SPC data on side effects) which caused them to miss days at work. Differences in efficacy and tolerability were observed between these interferons, in agreement with literature.

COPAXONE caused minimal side effects, but P complained about the multiple administrations.

GILENYA as second-line treatment was the best tolerated with no side effects.

In twenty cases, in response to P complaints, treatment was switched to a different drug. Thirteen of these P subsequently exhibited better compliance, while 7 were dissatisfied with the different treatment as well.

The treatments of these twenty P were switched for two reasons. In fifteen cases, the switch was motivated by side effects, while in the remaining five, the change was due to reactivation of the pathology.

Conclusion Compliance with all the MS treatments is generally very high. The same active ingredient has given different outcomes therefore it is recommended to switch the treatment.

References and/or acknowledgements

  1. Nikfar S, Rahimi R, Abdollahi M. A meta-analysis of the efficacy and tolerability of interferon-β in multiple sclerosis, overall and by drug and disease type. Clin Ther 2010;32(11):1871–88

References and/or acknowledgementsNo conflict of interest.

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