Yao Lingya, Zhu Xiao, Shao Bule, Liu Rongbei, Li Zhilun, Wu Lexi, Chen Jin, Cao Qian
Department of Gastroenterology, Sir Run Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou, China.
Medical Affairs, Janssen, China.
Front Pharmacol. 2021 Nov 22;12:736149. doi: 10.3389/fphar.2021.736149. eCollection 2021.
Ustekinumab (UST) was approved in China for treating moderate-to-severe Crohn's disease (CD) in 2020. We aimed to identify the reasons and possible contributing factors for UST preference in Chinese patients with CD. We conducted a multicenter cross-sectional survey among patients with moderate to severe CD who underwent UST treatment in 27 hospitals. Patients completed a 46-item questionnaire that included information on demographics, clinical characteristics, reasons in favor of UST and shared decision-making perception. Logistic regression analysis was performed to examine the predictive factors of different UST preferences. Overall, 127 patients (73 males; mean age, 25.9 ± 9.9 years) completed the questionnaire. Most patients (74.8%) had biologic failure. The most common reason for the latest treatment disconnection was unresponsiveness to the previous medications. The major UST information sources were physicians (96.1%). Nearly half of the patients (44.9%) reported shared decision making regarding UST treatment. No difference was found in the decision-making patterns in terms of sex and age. The most influential reason for UST preference was "effectiveness" (77%, 98/127), followed by "safety" (65%, 83/127), "frequency of administration" (39%, 49/127), and "mode of administration" (37%, 47/127). Multivariate logistic regression analysis revealed that a positive self-rated health status was a contributing factor for UST preference with a low frequency of administration. This is the first multicenter survey of Chinese patients with CD to identify the possible contributing factors for UST preference. Treatment choice should be discussed with patients because individual preferences are determined by diverse factors.
优特克单抗(UST)于2020年在中国获批用于治疗中重度克罗恩病(CD)。我们旨在确定中国CD患者选择UST的原因及可能的影响因素。我们对在27家医院接受UST治疗的中重度CD患者进行了一项多中心横断面调查。患者完成了一份包含46个条目的问卷,内容涉及人口统计学、临床特征、选择UST的原因及共同决策认知。进行逻辑回归分析以检验不同UST偏好的预测因素。总体而言,127例患者(73例男性;平均年龄25.9±9.9岁)完成了问卷。大多数患者(74.8%)存在生物制剂治疗失败情况。最近一次治疗中断的最常见原因是对先前药物无反应。UST的主要信息来源是医生(96.1%)。近一半患者(44.9%)报告在UST治疗方面参与了共同决策。在决策模式方面,性别和年龄无差异。选择UST的最具影响力原因是“有效性”(77%,98/127),其次是“安全性”(65%,83/127)、“给药频率”(39%,49/127)和“给药方式”(37%,47/127)。多变量逻辑回归分析显示,自我评估健康状况良好是选择给药频率低的UST的一个影响因素。这是首次针对中国CD患者进行的多中心调查,以确定选择UST的可能影响因素。应与患者讨论治疗选择,因为个体偏好由多种因素决定。