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Management Strategies for Flu-Like Symptoms and Injection-Site Reactions Associated with Peginterferon Beta-1a:
Background:
Flu-like symptoms (FLSs) and injection-site reactions (ISRs) have been reported with interferon beta treatments for multiple sclerosis (MS). We sought to obtain consensus on the characteristics/management of FLSs/ISRs in patients with relapsing-remitting MS based on experiences from the randomized, placebo-controlled ADVANCE study of peginterferon beta-1a.
Methods:
ADVANCE investigators with a predefined number of enrolled patients were eligible to participate in a consensus-generating exercise using a modified Delphi method. An independent steering committee oversaw the development of two sequential Delphi questionnaires. An average rating (AR) of 2.7 or more was defined as consensus a priori.
Results:
Thirty and 29 investigators (ie, responders) completed questionnaires 1 and 2, respectively, representing 374 patients from ADVANCE. Responders reported that the incidence/duration of FLSs/ISRs in their typical patient generally declined after 3 months of treatment. Responders reached consensus that FLSs typically last up to 24 hours (AR = 3.17) and have mild/moderate effects on activities of daily living (AR = 3.34). Patients should initiate acetaminophen/nonsteroidal anti-inflammatory drug treatment on a scheduled basis (AR = 3.31) and change the timing of injection (AR = 3.28) to manage FLSs. Injection-site rotation/cooling and drug administration at room temperature (all AR ≥ 3.10) were recommended for managing ISRs. Patient education on FLSs/ISRs was advocated before treatment initiation.
Conclusions:
Delphi responders agreed on the management strategies for FLSs/ISRs and agreed that patient education is critical to set treatment expectations and promote adherence.
Insights
Investigator consensus was reached on managing flu-like symptoms and injection-site reactions in multiple sclerosis patients treated with peginterferon beta-1a. Patient education and scheduled medication are key for managing these common interferon side effects.
Area of Science:
- Neurology
- Pharmacology
- Clinical Research
Background:
- Interferon beta therapies for multiple sclerosis (MS) are associated with flu-like symptoms (FLSs) and injection-site reactions (ISRs).
- Understanding and managing these adverse events is crucial for patient adherence and treatment success in relapsing-remitting MS (RRMS).
Purpose of the Study:
- To achieve expert consensus on the characteristics and management strategies for FLSs and ISRs in RRMS patients receiving peginterferon beta-1a.
- To leverage real-world clinical experience from the ADVANCE study to inform treatment guidelines.
Main Methods:
- A modified Delphi method was employed, involving eligible investigators from the ADVANCE study.
- Two sequential questionnaires were developed and administered, overseen by an independent steering committee.
- Consensus was defined as an average rating of 2.7 or higher on questionnaire items.
Main Results:
- Thirty investigators completed both questionnaires, representing 374 patients.
- Consensus indicated that FLSs and ISRs generally decrease after three months of treatment.
- FLSs typically last up to 24 hours and have mild/moderate impact on daily activities; scheduled acetaminophen/NSAIDs and injection timing adjustments are recommended.
- ISRs management includes injection-site rotation, cooling, and room temperature drug administration.
- Proactive patient education regarding FLSs/ISRs was strongly advocated.
Conclusions:
- Investigator consensus was achieved on effective management strategies for FLSs and ISRs.
- Patient education prior to treatment initiation is critical for setting expectations and improving adherence to interferon beta therapy.
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