Division of Gastroenterology, Ulster Hospital, Dundonald, Belfast, N Ireland BT16 1RH, UK.
BMC Gastroenterol. 2010 Jan 10;10:1. doi: 10.1186/1471-230X-10-1.
Infliximab is usually administered by two monthly intravenous (iv) infusions, therefore requiring visits to hospital. Adalimumab is administered by self subcutaneous (sc) injections every other week. Both of these anti-TNF drugs appear to be equally efficacious in the treatment of Crohn's Disease and therefore the decision regarding which drug to choose will depend to some extent on patient choice, which may be based on the mode of administration.The aims of this study were to compare preferences in Inflammatory Bowel Disease (IBD) patients for two currently available anti-TNF agents and the reasons for their choices.
An anonymous questionnaire was distributed to IBD patients who had attended the Gastroenterology service (Ulster Hospital, Dundonald, Belfast, N. Ireland. UK) between January 2007 and December 2007. The patients were asked in a hypothetical situation if the following administering methods of anti-TNF drugs (intravenous or subcutaneous) were available, which drug route of administration would they choose.
One hundred and twenty-five patients fulfilled the inclusion criteria and were issued questionnaires, of these 78 questionnaires were returned (62 percent response). The mean age of respondent was 44 years. Of the total number of respondents, 33 patients (42 percent) preferred infliximab and 19 patients (24 percent) preferred adalimumab (p = 0.07). Twenty-six patients (33 percent) did not indicate a preference for either biological therapy and were not included in the final analysis. The commonest reason cited for those who chose infliximab (iv) was: "I do not like the idea of self-injecting," (67 percent). For those patients who preferred adalimumab (sc) the commonest reason cited was: "I prefer the convenience of injecting at home," (79 percent). Of those patients who had previously been treated with an anti-TNF therapy (n = 10, all infliximab) six patients stated that they would prefer infliximab if given the choice in the future (p = 0.75).
There was a trend towards patient preference for infliximab (iv) treatment as opposed to adalimumab (sc) in patients with IBD. This difference may be due to the frequency of administration, mode of administration or differing 'times in the market-place', as infliximab had been approved for a longer period of time in Crohn's disease. Further studies are required in IBD patients to investigate whether patient choice will affect compliance, patient satisfaction and efficacy of treatment with anti-TNF therapies.
英夫利昔单抗通常每两个月通过静脉（iv）输注一次，因此需要到医院就诊。阿达木单抗每两周通过自我皮下（sc）注射一次。这两种抗 TNF 药物在治疗克罗恩病方面似乎同样有效，因此选择哪种药物在某种程度上取决于患者的选择，而这种选择可能基于给药方式。本研究的目的是比较炎症性肠病（IBD）患者对两种现有抗 TNF 药物的偏好，以及他们选择这些药物的原因。
2007 年 1 月至 12 月期间，向在北爱尔兰贝尔法斯特邓多纳德阿尔斯特医院消化科就诊的 IBD 患者分发了一份匿名问卷。在假设的情况下，如果有以下抗 TNF 药物（静脉或皮下）的给药方式，患者会选择哪种药物途径。
125 名符合纳入标准的患者收到了问卷，其中 78 份问卷（62%的应答率）被返回。应答者的平均年龄为 44 岁。在总应答者中，33 名患者（42%）更喜欢英夫利昔单抗，19 名患者（24%）更喜欢阿达木单抗（p = 0.07）。26 名患者（33%）没有对任何一种生物治疗方法表示偏好，因此未纳入最终分析。选择英夫利昔单抗（iv）的最常见原因是：“我不喜欢自我注射的想法”（67%）。选择阿达木单抗（sc）的最常见原因是：“我更喜欢在家注射的方便”（79%）。在之前接受过抗 TNF 治疗的患者中（n = 10，均为英夫利昔单抗），6 名患者表示如果有选择，他们将来会更喜欢英夫利昔单抗（p = 0.75）。
IBD 患者倾向于选择英夫利昔单抗（iv）治疗而非阿达木单抗（sc）治疗。这种差异可能是由于给药频率、给药方式或不同的“市场时间”所致，因为英夫利昔单抗在克罗恩病中的批准时间更长。需要在 IBD 患者中进行进一步的研究，以调查患者选择是否会影响抗 TNF 治疗的依从性、患者满意度和疗效。
