BACKGROUND: Injectable disease-modifying drugs (DMDs) reduce the number of relapses and delay disability progression in RRMS’ers. Regular self-injection can be stressful and impeded by MS symptoms. Auto-injection devices can simplify self-injection, overcome injection-related issues, and increase treatment satisfaction. This study investigated patient responses to an electronic auto-injection device.
METHODS: RRMS’ers (n = 63), aged 18-65 years, naïve to subcutaneous (sc) interferon (IFN) β-1a therapy, were recruited to a Phase IV, observational, open-label, multicenter study (NCT01195870). MS’ers self-injected sc IFN β-1a using the RebiSmart™ (Merck Serono S.A. – Geneva, Switzerland) electronic auto-injector for 12 weeks, including an initial titration period if recommended by the prescribing physician. In week 12, MS’ers completed a questionnaire comprising of a visual analog scale (VAS) to rate how much they liked using the device, a four-point response question on ease of use (‘very difficult’, ‘difficult’, ‘easy’, or ‘very easy’), and a list of ten device functions to rank, based upon their experiences.
RESULTS: Six MS’ers (9.5%) discontinued the study: one switched to manual injection; two discontinued all treatment; three changed therapy. In total, 59 out of 63 MS’ers (93.7%) completed the VAS; 54 out of 59 (91.5%; 95% confidence interval: 81.3%-97.2%) ‘liked’ using the electronic auto-injector (score ≥6), whereas 57 out of 59 (96.6%) rated the device overall as ‘easy’ or ‘very easy’ to use. Device features rated as most useful were the hidden needle (mean [standard deviation] score: 3.3 [3.01]; n = 56), confirmation sound (3.9 [2.45]), and multidose cartridge (4.6 [2.32]). The least useful functions were the dose history list (8.0 [2.57]) and dose history calendar (7.5 [2.30]).
CONCLUSIONS: These findings suggest that the electronic auto-injector may be suitable for MS’ers who are new to injectable DMD therapy. Devices that simplify the injection process may help to ensure that MS’ers receive the full benefits of treatment.
“The results suggest that MSers like the autoinjectors; or more useful comparison would be to see how MS’ers established on a treatment rate the device if switched. Our MS clinical nurse specialists have concerns about the device; complicated to use and they are worried about it malfunctioning. I would be interested to hear their thoughts on the paper.”
“If you are switcher to RebiSmart let us known how you rate the device?”
CoI: multiple
I used to be on Copaxone (2006-2010) and am now on Rebif (2011-). I manually injected Copaxone – more control (e.g. I could "prick around" to find a less sensitive spot and could inject at any angle I liked) and the autoinject was pretty pointless given the fact all it did was enclose the syringe and then shove it into your flesh at great speed. I have been using the Rebismart since July 2011. Overall, I am happy with it. I have had one technical problem with it for which I phoned the help line. A change of batteries sorted things out, but did reset the settings at the lowest levels – which I didn't discover for a couple of weeks: my stomach injections were leaking badly – I thought I was doing something wrong initially, but the depth settings had been reset to 4mm. Had I been a technophobe, I may not have discovered this. I have also played around with the settings to reduce bruising. Some people may not be comfortable doing this either?The Rebismart is sheer genius for needlephobes: the little cardboard cup with the needles in it means that you don't even need to see the needle. The needle itself is amazingly fine too – much thinner than the Copaxone needle, so the injections hurt less. I do think it's over-complicated though – why so many options? It's also slow – manual injecting is significantly quicker! It's pretty nifty though 🙂 Shame they can't do anything about the side effects; then it would beat Copaxone hands down.