MS Drug Adherence Better, But Still Suboptimal, With Oral Therapies

Medication adherence appears better with oral compared with injectable disease-modifying therapy (DMT) for multiple sclerosis, but adherence and persistence for both oral and injectable therapies are inadequate, according to study findings.

“People with multiple sclerosis may be prescribed DMT,” the study explained, “which is administered through self-injectable, oral, or intravenous administration routes; injectable and oral administration routes are associated with suboptimal adherence and persistence.”

Researchers conducted a systematic review, meta-analysis, and meta-regression to see whether the relatively recent introduction of oral DMT improved medication adherence, compared with injectable DMT, in people with multiple sclerosis. A total 61 articles were included, with 46 addressing adherence and 26 addressing discontinuation.

Medication adherence appeared significantly higher for oral compared with injectable DMT, the study found.

“When compared with injectable DMTs and measured using mean adherence, meta-regression showed a 14% significant improvement in 12-month medication adherence for oral DMTs,” researchers reported. “The improvement contrasted with a 12-month oral and injectable adherence using a cut-off score of at least 80% to determine adherence, which showed no significant difference.”

What’s more, 12-month discontinuation rates for oral and injectable DMT did not differ appreciably: discontinuation rates averaged 24% with oral and 27% with injectable DMT.

The findings highlight the continued need for interventions to boost medication compliance, researchers pointed out.

“The improvement in adherence of oral DMTs compared with injectable DMTs highlights a benefit of oral DMT administration that will translate into improved clinical outcomes for people with multiple sclerosis yet does not solve the problem of suboptimal medication adherence and persistence,” they wrote. “Thus, people with multiple sclerosis continue to require support to develop strategies to take their medication as prescribed.”

Reference:
Mardan J, Hussain MA, Allan M, Grech LB. Objective medication adherence and persistence in people with multiple sclerosis: a systematic review, meta-analysis, and meta-regression. J Manag Care Spec Pharm. 2021;27(9):1273-1295. doi:10.18553/jmcp.2021.27.9.1273