Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia, Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia, and Concord Repatriation and General Hospital, Concord, New South Wales, Australia.
Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia, Liverpool Hospital and Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia, and Western Sydney Clinical School, University of New South Wales Medicine, Sydney, New South Wales, Australia.
Arthritis Care Res (Hoboken). 2022 Aug;74(8):1234-1243. doi: 10.1002/acr.24782. Epub 2022 Jun 1.
We aimed to assess patient preferences for the characteristics and outcomes of biologic and targeted synthetic disease-modifying antirheumatic drugs (DMARDs) to manage psoriatic arthritis.
We conducted a discrete choice experiment in patients with psoriatic arthritis from 3 rheumatology centers in Sydney, Australia. We assessed preferences for different attributes of biologic medications. The route and frequency of medications had a range of 5 levels, and the following 7 attributes had a range of 3 levels: the ability to attend to normal activities, improvements in joint pain, enthesitis and skin disease, chance of disease remission, risk of infection, and risk of severe adverse events. Multinomial logit models including a latent class model were used to calculate preferences.
Of the 150 participants, 58.3% were female, with a median age of 53.5 years. The attributes in order of preference using the β coefficient in absolute values (95% confidence interval [95% CI]) were as follows: oral route compared to subcutaneous and intravenous routes (β coefficient 1.00 [fixed parameter]), avoiding severe side effects (β coefficient 0.72 [95% CI 0.50, 0.95]), increasing ability to attend to normal activities (β coefficient 0.66 [95% CI 0.36, 0.96]), avoiding infections (β coefficient 0.38 [95% CI 0.23, 0.53]), improvement in enthesitis pain (β coefficient 0.28 [95% CI 0.20, 0.36]), improvement in psoriasis (β coefficient 0.28 [95% CI 0.20, 0.36]), increasing chance of remission (β coefficient 0.27 [95% CI 0.19, 0.36]), and improvement in joint pain (β coefficient 0.26 [95% CI 0.00, 0.52]).
When choosing biologic medications, patients with psoriatic arthritis preferred oral medications. Patients prioritized avoiding severe complications, maintaining the ability to attend to work and normal activities, and avoiding infection over clinical measures of efficacy.
我们旨在评估患者对生物制剂和靶向合成改善病情抗风湿药物（DMARDs）治疗银屑病关节炎的特征和结局的偏好。
我们在澳大利亚悉尼的 3 个风湿病中心开展了一项离散选择实验，评估了患者对生物药物不同属性的偏好。药物的给药途径和频率有 5 个水平，以下 7 个属性有 3 个水平：参加正常活动的能力、关节痛、附着点炎和皮肤疾病的改善、疾病缓解的机会、感染风险和严重不良事件风险。使用多项逻辑回归模型（包括潜在类别模型）计算偏好。
在 150 名参与者中，58.3%为女性，中位年龄为 53.5 岁。按照绝对值（95%置信区间[95%CI]）β系数排序的偏好属性如下：口服途径优于皮下和静脉途径（β系数 1.00[固定参数]），避免严重副作用（β系数 0.72[95%CI 0.50，0.95]），增加参加正常活动的能力（β系数 0.66[95%CI 0.36，0.96]），避免感染（β系数 0.38[95%CI 0.23，0.53]），附着点炎疼痛改善（β系数 0.28[95%CI 0.20，0.36]），银屑病改善（β系数 0.28[95%CI 0.20，0.36]），缓解机会增加（β系数 0.27[95%CI 0.19，0.36]），关节痛改善（β系数 0.26[95%CI 0.00，0.52]）。
在选择生物制剂时，银屑病关节炎患者更倾向于口服药物。与临床疗效指标相比，患者更优先考虑避免严重并发症、保持参加工作和正常活动的能力以及避免感染。
