1Murad Al-Naqshbandi, 1Hoda Joudi, 1Abed Raki

1Merck Serono Middle East FZ-Ltd (an affiliate of Merck KGaA), Dubai, United Arab Emirates


Several factors rendered patients with multiple sclerosis (pwMS) likely to be affected by the rapidly evolving events of the COVID-19 pandemic. Globally, pwMS were confronted with limited access to their healthcare team, potential treatment interruption, and concerns about the risk of infection while treated with immunomodulatory disease-modifying therapies (DMTs), particularly high-efficacy DMTs [1,2]. The current study explored treatment-related concerns and their impact on medication adherence during the COVID-19 pandemic in pwMS treated with subcutaneous interferon beta-1a (sc IFN β-1a) in the Near East region.

Material(s) and Method(s):

A total of 3,348 pwMS treated with sc IFN β-1a across five countries of the Near East region (Iran, Iraq, Jordan, Lebanon, and Palestine) participated in a telephone survey. The survey was conducted by nurses, on behalf of the Merck Patient Support Program in the Near East region, from May 1–30, 2021. A standardized questionnaire allowed participants to report their concerns related to COVID-19 and their MS treatment, along with medication adherence over the previous 3 months. Concern with current MS treatment was rated on a scale of 1–10, with levels 1–3 reflecting a low level of concern, levels 4–7 reflecting a moderate level of concern, and levels 8–10 reflecting a high level of concern. Adherence to sc IFN β-1a was defined as administration of the prescribed three weekly injections.


Amongst the countries surveyed, a total of 3,074 participants (92%) reported being concerned about sc IFN β-1a increasing their risk of COVID-19 infection. However, a majority of participants from Iraq (94%), Palestine (88%), Jordan (84%), and Iran (84%) reported a low level of concern (Figure 1). More participants from Lebanon reported high (51%) and moderate (38%) levels of concern about their MS treatment and the risk of COVID-19 infection. Full adherence to sc IFN β-1a over the previous 3 months was reported by 3,293 (98%) participants (Figure 2). Key factors influencing medication adherence included the lack of access to sc IFN β-1a, physician supervision, and adverse events.


This study explored the impact of treatment-related concerns on medication adherence in pwMS treated with sc IFN β-1a during the COVID-19 pandemic in the Near East. Despite a large proportion of study participants being concerned about a potential increase in the risk of COVID-19 infection while on their current treatment, participants were only mildly concerned and the majority remained adherent to the prescribed medication. Furthermore, the fear of COVID-19 infection by participants was not a key factor associated with non-adherence. Instead, limited access to medication and decisions of supervising physicians negatively impacted medication adherence. More than a year after the World Health Organization declared the COVID-19 outbreak a pandemic, safety concerns related to DMTs still exist. Interferons can be prescribed as usual in COVID-19 times [3], and this should be communicated effectively to clinicians and patients.