Department of Gastroenterology and Hepatology, University Hospital Zurich, Switzerland.
Inflamm Bowel Dis. 2012 Aug;18(8):1523-30. doi: 10.1002/ibd.21888. Epub 2011 Oct 10.
Infliximab (IFX), adalimumab (ADA), and certolizumab pegol (CZP) have similar efficacy in induction and maintenance of clinical remission in Crohn's disease (CD). Given the comparable nature of these drugs, patient preferences may influence the choice of the product. We aimed to identify factors that may contribute to CD patients' decision in selecting one anti-tumor necrosis factor (TNF) agent over the others.
A prospective survey was performed among anti-TNF-naïve CD patients. Prior to completion of a questionnaire, patients were provided with a written description of the three anti-TNF agents, focusing on indications, mode of administration, side effects, and scientific evidence of efficacy and safety for each drug.
One hundred patients (47 females, mean age 45 ± 16 years, range 19-81) with an ileal, colonic, or ileocolonic (33%, 40%, and 27%, respectively) disease location completed the questionnaire. Based on the information provided, 36% of patients preferred ADA, 28% CZP, and 25% IFX, whereas 11% were undecided. The patients' decision in selecting a specific anti-TNF drug was influenced by the following factors: ease of use (69%), time required for therapy (34%), time interval between application of the drug (31%), scientific evidence for efficacy (19%), and fear of syringes (10%).
The majority of patients preferred anti-TNF medications that were administered by subcutaneous injection rather than by intravenous infusion. Ease of use and time required for therapy were two major factors influencing the patients' selection of a specific anti-TNF drug. Patients' individual preferences should be taken into account when prescribing anti-TNF drugs.
英夫利昔单抗（IFX）、阿达木单抗（ADA）和培塞利珠单抗（CZP）在诱导和维持克罗恩病（CD）的临床缓解方面具有相似的疗效。鉴于这些药物的性质相似，患者的偏好可能会影响产品的选择。我们旨在确定可能影响 CD 患者选择一种抗肿瘤坏死因子（TNF）药物而不是其他药物的因素。
对抗 TNF 初治 CD 患者进行前瞻性调查。在完成问卷之前，向患者提供了三种抗 TNF 药物的书面说明，重点介绍了每种药物的适应症、给药方式、副作用以及疗效和安全性的科学证据。
100 名患者（47 名女性，平均年龄 45±16 岁，范围 19-81 岁）具有回肠、结肠或回结肠疾病部位（分别为 33%、40%和 27%），完成了问卷。根据提供的信息，36%的患者更喜欢 ADA，28%的患者更喜欢 CZP，25%的患者更喜欢 IFX，而 11%的患者犹豫不决。患者选择特定抗 TNF 药物的决定受到以下因素的影响：使用方便（69%）、治疗所需时间（34%）、药物给药间隔（31%）、疗效的科学证据（19%）和对注射器的恐惧（10%）。
大多数患者更喜欢通过皮下注射而不是静脉输注给药的抗 TNF 药物。使用方便和治疗所需时间是影响患者选择特定抗 TNF 药物的两个主要因素。在开具抗 TNF 药物时，应考虑患者的个体偏好。
