Open Access Research article

The prevalence of injection-site reactions with disease-modifying therapies and their effect on adherence in patients with multiple sclerosis: an observational study

Karsten Beer1*, Martin Müller2, Anna Marie Hew-Winzeler3, Adriano Bont4, Philippe Maire5, Xiaojun You6, Pamela Foulds6, Jessica Mårlind7 and Daniela Curtius7

Author Affiliations

1 Private practice, Obere Bahnhofstrasse, CH 9500, Wil, Switzerland

2 Department of Medicine, Canton Hospital of Lucerne, Lucerne, Switzerland

3 Private practice, Todistrasse 46, CH 8002, Zurich, Switzerland

4 Private practice, Brunngasse 6, CH 8400, Winterthur, Switzerland

5 Hirslanden Clinic Aarau, Schanisweg, CH 5001, Aarau, Switzerland

6 Biogen Idec Inc., 133 Boston Post Road, Weston, MA, USA

7 Biogen-Dompé AG, Bundesplatz 9, CH 6300, Zug, Switzerland

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BMC Neurology 2011, 11:144  doi:10.1186/1471-2377-11-144

Published: 10 November 2011



Interferon beta (IFNβ) and glatiramer acetate (GA) are administered by subcutaneous (SC) or intramuscular (IM) injection. Patients with multiple sclerosis (MS) often report injection-site reactions (ISRs) as a reason for noncompliance or switching therapies. The aim of this study was to compare the proportion of patients on different formulations of IFNβ or GA who experienced ISRs and who switched or discontinued therapy because of ISRs.


The Swiss MS Skin Project was an observational multicenter study. Patients with MS or clinically isolated syndrome who were on the same therapy for at least 2 years were enrolled. A skin examination was conducted at the first study visit and 1 year later.


The 412 patients enrolled were on 1 of 4 disease-modifying therapies for at least 2 years: IM IFNβ-1a (n = 82), SC IFNβ-1b (n = 123), SC IFNβ-1a (n = 184), or SC GA (n = 23). At first evaluation, ISRs were reported by fewer patients on IM IFNβ-1a (13.4%) than on SC IFNβ-1b (57.7%; P < 0.0001), SC IFNβ-1a (67.9%; P < 0.0001), or SC GA (30.4%; P = not significant [NS]). No patient on IM IFNβ-1a missed a dose in the previous 4 weeks because of ISRs, compared with 5.7% of patients on SC IFNβ-1b (P = 0.044), 7.1% of patients on SC IFNβ-1a (P = 0.011), and 4.3% of patients on SC GA (P = NS). Primary reasons for discontinuing or switching therapy were ISRs or lack of efficacy. Similar patterns were observed at 1 year.


Patients on IM IFNβ-1a had fewer ISRs and were less likely to switch therapies than patients on other therapies. This study may have implications in selecting initial therapy or, for patients considering switching or discontinuing therapy because of ISRs, selecting an alternative option.