Background and aim

Peginterferon beta-1a (Plegridy) offers the advantage of a prolonged half-life with less-frequent administration and a higher patient adherence. However, the use of an interferon may lead to flu-like symptoms (FLS) and injection-site reactions (ISR) that results in drug discontinuation. The objective of this Delphi analysis was to obtain consensus on the characteristics and management of FLS/ISR of peginterferon beta-1a in patients with relapsing-remitting MS based on real-world clinical experiences.4

Methods

A steering committee of MS neurologists and nurses identified issues regarding the features and management of adverse events and generated a questionnaire used to conduct three rounds of the Delphi web survey with an Italian expert panel (54 neurologists and nurses).

Results

Fifty-three (100%), fifty-one (96.22%), and forty-two (79.24%) responders completed questionnaires 1, 2, and 3 respectively. Responders reported that, during the first 6 months of treatment, FLS generally occurred 6–12 h after injection; the fever tended to resolve after 12–24 h; otherwise, FLS lasted up to 48 h. FLS improved or disappeared after 6 months of treatment in most cases. Paracetamol was recommended as the first choice for managing FLS. Erythema was the most common ISR and usually resolved within 1 week after injection. Responders reported that the adherence to treatment increases after adequate patient education on the drug’s tolerability profile.

Conclusions

Patient education and counseling play a key role in promoting adherence to treatment especially in the first months also in patients switching from nonpegylated IFNs to peginterferon beta-1a.

中文翻译：

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聚乙二醇干扰素β-1a（Plegridy）意大利的真实经验：注射部位反应和流感样症状管理的Delphi分析

背景和目标

聚乙二醇干扰素β-1a（Plegridy）具有延长半衰期，减少给药频率和提高患者依从性的优势。但是，使用干扰素可能会导致类似流感的症状（FLS）和注射部位反应（ISR），从而导致药物停药。德尔菲分析的目的是根据现实世界的临床经验，对复发缓解型MS患者聚乙二醇干扰素β-1a的FLS / ISR的特征和治疗达成共识4。

方法

MS神经病学家和护士的指导委员会确定了与不良事件的特征和管理有关的问题，并生成了一个问卷，用于与意大利专家小组（54位神经病学家和护士）进行三轮Delphi网络调查。

结果

分别有53（100％），51（96.22％）和42（79.24％）的受访者填写了问卷1、2和3。响应者报告说，在治疗的前6个月中，FLS通常在注射后6-12小时内发生。发烧倾向于在12-24小时后消退；否则，FLS持续长达48小时。在大多数情况下，治疗6个月后FLS改善或消失。推荐扑热息痛为治疗FLS的首选药物。红斑是最常见的ISR，通常在注射后1周内消失。响应者报告说，在对患者的药物耐受性进行了充分的教育之后，对治疗的依从性增加了。

结论

病人的教育和咨询在促进对治疗的依从性方面起着关键作用，尤其是在最初几个月中，从非聚乙二醇化干扰素转换为聚乙二醇干扰素β-1a的病人中也是如此。