M. Jeffery1, A. Stokes 1, K. Johnson 1, D. Anderson 2, B. Harper 2. 1BA Hons Politics, The Research Partnership Ltd., London, United Kingdom, 2Rheumatology Research International, RRI, Dallas, TX, United States

Background: TNF antagonists have proven safe and effective in relieving signs and symptoms and inhibiting radiographic progression of rheumatoid arthritis. The TNF antagonists–adalimumab, etanercept, and infliximab–have different dose regimens and administration methods.Objectives: We conducted this study to determine patient preferences for administration methods.Methods: Face-to-face interviews lasting approximately 20-30 minutes were conducted with patients from Europe (EU) and the United States (US) between November 2002 and August 2003. In the EU, the interviews were conducted in 3 countries: Germany, Spain and the United Kingdom in the respondent's native language. In the US, the interviews were conducted across the country in 7 geographic regions. Patient selection criteria included physician diagnosis of RA, currently taking antirheumatic drugs, and physical function assessment suggesting moderate to severe disease. The patient sample was intended to contain 80% currently on traditional DMARDs and 20% taking biologic DMARDs in the EU and 65% traditional DMARDs and 35% biologic DMARDs in the US, to reflect anticipated demographics of moderate to severe RA patients in respective clinical settings. Patients were shown detailed schematics and instructions to illustrate the steps associated with each administration method, and questions about preference of various aspects of each option were posed. No product names were associated with the administration methods, and the order in which they were presented to the patient was randomized. In both the EU and the US, chi-square test was performed on overall preferences to determine significance.Results: Interviews were conducted with 300 patients (100 patients from each country) in the EU and 174 patients in the US. In EU, the 60 patients on biologic DMARDs were taking infliximab (62%), etanercept (35%) and anakinra (3%). In the US, of 43% on biologics, 38 (51%), 22 (30%), 10 (14%) and 4 (5%) were taking infliximab, etanercept, adalimumab and anakinra, respectively. Overall, 75% of the EU respondents were greater than or equal to 50 years of age and the mean age for the US respondents was 57. Female respondents consisted of 77% in the EU and 79% in the US. Less than 25% of patients in the EU and 18% in the US preferred an IV infusion to subcutaneous (sc) injection and only 15% and 13% of patients responded that they preferred receiving their medication in a hospital setting. A "ready to use" pre-filled syringe was preferred by 77% of EU and 81% of US patients when compared with products that require reconstitution or administered by a nurse. Overall, 75% of patients in the EU and 73% (p<0.0001) in the US preferred a product administered sc every other week and supplied in pre-filled syringe over one administered sc twice a week that also required reconstitution and one administered intravenously every 8 weeks in a hospital.Conclusion: Overall, whether experienced with biologic DMARDs or currently taking traditional DMARDs, surveyed patients with RA in the EU and US preferred the easier administration and convenient dosing of adalimumab over other currently available biologic DMARDs.

Session: Health services, economics and outcome research


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