S0812 Patients’ Preferences for Subcutaneous or Intravenous Administration Methods in Inflammatory Bowel Diseases

INTRODUCTION: A variety of biologic medications is available to treat inflammatory bowel disease (IBD), each with differing side-effect profiles, efficacy, and routes of administrations. These biologics are either administered intravenously (IV) or subcutaneously (SC), which can play a large role in patients‘ preferences for medications. Research in other conditions, including SLE, cancer and osteoporosis, shows that these preferences are highly personal. Here, we sought to assess IBD patients' preferences for IV and SC medications in a large survey of IBD patients in the US, Canada, and UK. METHODS: We performed a conjoint analysis survey to understand the importance of different medication attributes for IBD patients, including route of administration, efficacy, and side effects. Patients were recruited from the general population through a survey panel and from 30 clinical practices within the IBD Qorus Learning Health System. Preference estimates for different medication attributes were obtained using hierarchical Bayes modeling and patients‘ likelihood to prefer SC or IV medication was estimated in various scenarios. Predictors for stronger SC or IV preferences were identified in a multivariable linear regression model. RESULTS: In total, 1,077 patients with IBD completed the survey. If offered the choice between two medicines with the same efficacy and side-effects, 49% would prefer SC injections every 2 weeks over IV infusions every 8 weeks. If offered the choice between SC every 8 weeks and IV every 8 weeks, 67% would prefer SC. If the SC medicine given every 2 weeks was 10% less effective than the IV every 8 weeks option, only 24% would prefer the SC option; it dropped to 15% if the SC medicine was 30% less effective. Similar patterns were observed with higher risks of side-effect (Figure 1). Past or current experience with SC or IV medicines was a strong predictor for stronger SC and IV preferences, respectively. Older age and a college education were associated with SC preference (Table 1). CONCLUSION: Roughly half of IBD patients prefer SC administration every 2 weeks over IV infusions every 8 weeks. Past experience with a specific mode of administration is the most important predictor for this preference. However, if the SC option is less effective than the IV medication, >75% of patients would prefer the IV medicine, indicating that efficacy is more important than mode of administration in patients’ therapeutic decision making.Figure 1.: % of people preferring a medicine with subcutaneous (SC) over intravenous (IV) administration every 8 weeks. (A) A SC medicine administered at various time intervals compared to an IV medicine every 8 weeks, all else being equal; (B) A SC medicine every 2 weeks that is less efficacious than an IV medicine every 8 weeks; (C) A SC medicine every 2 weeks that has a higher risk of serious side effects than an IV medicine every 8 weeks; (D) A SC medicine every 2 weeks that has a higher risk of lymphoma than an IV medicine every 8 weeks.Table 1.: Multivariable linear regression model to predict strength of preference for SC every 2 weeks over IV every 8 weeks. *P < .05; **P < .01; ***P < .001; †1 unit represents 1 standard deviation. CD = Crohn’s disease; IBD = inflammatory bowel disease; IC = indeterminate colitis; UC = ulcerative colitis

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.