Document Type : Original Article
Authors
1 Department of Health Service Administration, Shiraz University of Medical Sciences, Shiraz, Iran
2 Health Human Resources Research Center, Department of Health Service Management, Shiraz University of Medical Sciences, Shiraz, Iran
3 Department of Health Economics, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract
Objective: There is an increasing recognition among clinicians and researchers that
the impact of chronic illnesses and their treatments must be assessed in terms of their
quality of life (QoL) in addition to more traditional measures of clinical outcomes. The
aim of this study was to compare the QoL in patients with relapsing‑remitting multiple
sclerosis (RRMS) using Avonex or CinnoVex.
Methods: We conducted a cross‑sectional study on one hundred patients with
RRMS, fifty and fifty patients were being treated with Avonex (Biogen Idec, USA) and
CinnoVex (CinnaGen, Iran), respectively. We used a disease‑specific questionnaire for
MS (Multiple Sclerosis Quality of Life‑54 [MSQoL‑54]). Both groups were tested for
significant differences regarding sociodemographic. A multiple linear regression model
was constructed to find factors that affected the different aspect of QoL of the whole
sample of patients.
Findings: MS groups did not differ in physical and mental health composite scores
as well as relative scales. The results of regression models for each subscale showed
that age, marriage, and Expanded Disability Status Scale were associated with several
subscales of the MSQoL‑54 (P < 0.05).
Conclusion: In this study, it was seen that there are no significant differences between
QoL of Avonex and CinnoVex, but a limitation in our study the results may be different
in other countries and even various areas in Iran.
Keywords
Johnson K. Cost‑effectiveness of four immunomodulatory
therapies for relapsing‑remitting multiple sclerosis: A Markov
model based on long‑term clinical data. J Manag Care Pharm
2007;13:245‑61.
2. Weinshenker BG, Bass B, Rice GP, Noseworthy J, Carriere W,
Baskerville J, et al. The natural history of multiple sclerosis: A
geographically based study. I. Clinical course and disability.
Brain 1989;112(Pt 1):133‑46.
3. Weinshenker BG, Bass B, Rice GP, Noseworthy J, Carriere W,
Baskerville J, et al. The natural history of multiple sclerosis:
A geographically based study 2. Predictive value of the early
clinical course. Brain 1989;112(Pt 6):1419‑28.
4. Lublin FD, Reingold SC. Defining the clinical course of
multiple sclerosis: Results of an international survey. National
Multiple Sclerosis Society (USA) Advisory Committee on
Clinical Trials of New Agents in Multiple Sclerosis. Neurology
1996;46:907‑11.
5. Richards RG, Sampson FC, Beard SM, Tappenden P. Areview
of the natural history and epidemiology of multiple sclerosis:
Implications for resource allocation and health economic
models. Health Technol Assess 2002;6:1‑73.
6. Jongen PJ, Sindic C, Carton H, Zwanikken C, Lemmens W,
Borm G; Functional Composite and Quality of Life in
Avonex‑treated Relapsing Multiple Sclerosis Patients Study
Group. Improvement of health‑related quality of life in relapsing
remitting multiple sclerosis patients after 2 years of treatment
with intramuscular interferon‑beta‑1a. J Neurol 2010;257:584‑9.
7. Panitch H, Goodin DS, Francis G, Chang P, Coyle PK,
O’Connor P, et al. Randomized, comparative study of
interferon beta‑1a treatment regimens in MS: The EVIDENCE
trial. Neurology 2002;59:1496‑506.
8. Johnson KP, Brooks BR, Cohen JA, Ford CC, Goldstein J,
Lisak RP, et al. Copolymer 1 reduces relapse rate and improves
disability in relapsing‑remitting multiple sclerosis: Results of a phase III multicenter, double‑blind placebo‑controlled trial.
The Copolymer 1 Multiple Sclerosis Study Group. Neurology
1995;45:1268‑76.
9. Kappos L, Traboulsee A, Constantinescu C, Erälinna JP,
Forrestal F, Jongen P, et al. Long‑term subcutaneous interferon
beta‑1a therapy in patients with relapsing‑remitting MS.
Neurology 2006;67:944‑53.
10. Etemadifar M, Maghzi AH, Hoseinzadeh A. Comparing
side effects of CinnoVex with Avonex in relapsing remitting
multiple sclerosis patients. J Isfahan Med Sch 2009;27:93‑100.
11. Etemadifar M, Mazdeh M, Torabi HR, Ghaffarpour M,
Azimian M, Salami S, et al. A report of multiple sclerosis
patients treated by CinnoVex™ in Iran. Tehran Univ Med J
2010;68:30‑6.
12. Nafissi S, Azimi A, Amini‑Harandi A, Salami S,
Shahkarami MA, Heshmat R. Comparing efficacy and side
effects of a weekly intramuscular biogeneric/biosimilar
interferon beta‑1a with Avonex in relapsing remitting multiple
sclerosis: A double blind randomized clinical trial. Clin Neurol
Neurosurg 2012;114:986‑9.
13. Arababadi MK, Mosavi R, Khorramdelazad H, Yaghini N,
Zarandi ER, Araste M, et al. Cytokine patterns after therapy
with Avonex®, Rebif®, Betaferon® and CinnoVex™ in
relapsing‑remitting multiple sclerosis in Iranian patients.
Biomark Med 2010;4:755‑9.
14. Sharafaddinzadeh N, Majdinasab N, Ghiasian M,
Moravej‑Aleali A. Efficacy of interferon β1a (Cinnovex) in
relapsing‑remitting multiple sclerosis patients. Zahedan J Res
Med Sci 2011;13:3‑6.
15. Hahl J, Hämäläinen H, Sintonen H, Simell T, Arinen S,
Simell O. Health‑related quality of life in type 1 diabetes
without or with symptoms of long‑term complications. Qual
Life Res 2002;11:427‑36.
16. Ardito SQ, Bestetti RB, Cardinalli‑Neto A, Otaviano AP,
NogueiraPR. Chronic renal impairment in patients with Chagas
cardiomyopathy with chronic systolic heart failure: Prevalence
and prognostic significance. Int J Cardiol 2011;152:133‑4.
17. Joshi VD, Mooppil N, Lim JF. Validation of the kidney
disease quality of life‑short form: A cross‑sectional study of a
dialysis‑targeted health measure in Singapore. BMC Nephrol
2010;11:36.
18. Ghaem H, Borhani Haghighi A, Jafari P, Nikseresht AR.
Validity and reliability of the Persian version of the
multiple sclerosis quality of life questionnaire. Neurol India
2007;55:369‑75.
19. Kurtzke JF. Rating neurologic impairment in multiple sclerosis:
An expanded disability status scale (EDSS). Neurology
1983;33:1444‑52.
20. Vickrey BG, Hays RD, Harooni R, Myers LW, Ellison GW.
Ahealth‑related quality of life measure for multiple sclerosis.
Qual Life Res 1995;4:187‑206.
21. Simone IL, CeccarelliA, Tortorella C, BellacosaA, Pellegrini F,
Plasmati I, et al. Influence of interferon beta treatment on
quality of life in multiple sclerosis patients. Health Qual Life
Outcomes 2006;4:96.
22. Pfaffenberger N, Pfeiffer KP, Deibl M, Höfer S, Günther V,
Ulmer H. Association of factors influencing health‑related
quality of life in MS. Acta Neurol Scand 2006;114:102‑8.
23. Fisk JD, Brown MG, Sketris IS, Metz LM, Murray TJ,
Stadnyk KJ. A comparison of health utility measures for
the evaluation of multiple sclerosis treatments. J Neurol
Neurosurg Psychiatry 2005;76:58‑63