Kishimoto Mitsumasa, Yamairi Fumiko, Sato Noriko, Kobayashi Jun, Yamauchi Saori, Iwasaki Tomohisa
Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2 Shinkawa Mitaka, Tokyo, 181-8611, Japan.
Medical Intelligence Department, Ikuyaku. Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan.
Rheumatol Ther. 2021 Sep;8(3):1095-1111. doi: 10.1007/s40744-021-00325-9. Epub 2021 Jun 5.
Although the proportion of patients with rheumatoid arthritis (RA) using biologic disease-modifying antirheumatic drugs (bDMARDs) has increased steadily, the relationship between patient background and preference for bDMARDs has not been fully investigated.
We conducted a web-based questionnaire survey among patients aged ≥ 20 years with RA receiving bDMARDs. Participants were recruited through an internet research company in Japan. Study endpoints included factors affecting the preferred bDMARD treatment mode, namely, in-hospital intravenous infusion (infusion), in-hospital subcutaneous injection (in-hospital injection), or self-administered subcutaneous injection (self-injection), and discrepancies between the current and preferred treatment mode.
Of the 400 patients surveyed for preferred treatment mode, 15.3% preferred infusion, 18.0% preferred in-hospital injection, and 66.8% preferred self-injection. A preference for infusion (odds ratio [OR] 2.218 and 6.165) and in-hospital injection (OR 4.735 and 6.026) versus self-injection was significantly associated with higher current frequency of hospital visits and anxiety or other hurdles related to self-injection. A flexible administration setting was significantly associated with a preference for self-injection versus infusion (OR 0.401) and versus in-hospital injection (OR 0.445). Further, age (< 40 vs. ≥ 60 years) was significantly associated with a preference for self-injection versus in-hospital injection (OR 0.120). Many patients reported no discrepancy between their current and preferred treatment mode (patients receiving infusion, 68.0%; in-hospital injection, 71.2%; and self-injection, 94.0%). However, > 90% of patients responded that they would change their current mode in the future following a recommendation by a medical professional, aging, or a change in RA symptoms.
This web-based survey showed that patient preference for bDMARD treatment mode was significantly associated with age, frequency of hospital visits, flexible administration setting, and anxiety or other hurdles to self-injection. Changes in patient background which affect the preferred treatment mode should be considered in decision-making for RA therapy with bDMARDs.
R000048089 (UMIN-CTR).
尽管使用生物改善病情抗风湿药（bDMARDs）的类风湿关节炎（RA）患者比例稳步上升，但患者背景与bDMARDs偏好之间的关系尚未得到充分研究。
我们对年龄≥20岁且正在接受bDMARDs治疗的RA患者进行了一项基于网络的问卷调查。参与者通过日本的一家互联网研究公司招募。研究终点包括影响首选bDMARD治疗方式的因素，即院内静脉输注（输液）、院内皮下注射（院内注射）或自我皮下注射（自我注射），以及当前治疗方式与首选治疗方式之间的差异。
在400名接受首选治疗方式调查的患者中，15.3%的患者首选输液，18.0%的患者首选院内注射，66.8%的患者首选自我注射。与自我注射相比，对输液（优势比[OR]为2.218和6.165）和院内注射（OR为4.735和6.026）的偏好与当前较高的就诊频率以及与自我注射相关的焦虑或其他障碍显著相关。灵活的给药环境与相对于输液（OR为0.401）和院内注射（OR为0.445）而言对自我注射的偏好显著相关。此外，年龄（<40岁与≥60岁）与相对于院内注射而言对自我注射的偏好显著相关（OR为0.120）。许多患者报告他们当前的治疗方式与首选治疗方式之间没有差异（接受输液的患者为68.0%；院内注射的患者为71.2%；自我注射的患者为94.0%）。然而，超过90%的患者表示，在医学专业人员的建议、年龄增长或RA症状改变后，他们未来会改变当前的治疗方式。
这项基于网络的调查显示，患者对bDMARD治疗方式的偏好与年龄、就诊频率、灵活的给药环境以及自我注射的焦虑或其他障碍显著相关。在使用bDMARDs进行RA治疗的决策中，应考虑影响首选治疗方式的患者背景变化。
R000048089（UMIN-CTR）
