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      Patient Preference and Adherence (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on the growing importance of patient preference and adherence throughout the therapeutic process. Sign up for email alerts here.

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      Preference for a prefilled syringe or an auto-injection device for delivering golimumab in patients with moderate-to-severe ulcerative colitis: a randomized crossover study

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          Abstract

          Purpose

          Simponi ® (golimumab, MSD) is a fully human monoclonal antibody against tumor necrosis factor alpha administered subcutaneously using an autoinjector or a prefilled syringe. This study examined preference for administration of golimumab by autoinjector or prefilled syringe in patients with moderate-to-severe ulcerative colitis (UC).

          Patients and methods

          This was a multicenter, open-label, randomized crossover trial (EudraCT no 2014-000656-29). Patients with moderate-to-severe UC were randomized 1:1 to receive 2 subcutaneous injections of 50 mg golimumab with the autoinjector followed by 2 injections of 50 mg with the prefilled syringe or the same 4 injections administered in the opposite order. Patients assessed preference, ease of use, and discomfort immediately after the injections and 2 weeks later.

          Results

          Ninety-one patients were included (median age=42.7 years [range, 19.7–93.7]; 58% male). The autoinjector was preferred by 76.9% of patients immediately after injections and by 71.4% 2 weeks later. The autoinjector was more often considered extremely easy or easy to use (94.5%) than the prefilled syringe (73.6%). Moderate discomfort or worse was reported by more patients when using the prefilled syringe (20.9%) than when using the autoinjector (5.5%), and severe discomfort or discomfort preventing injection of future doses was reported by 8.8% for the pre-filled syringe but not at all when using the autoinjector. A favorable or extremely favorable overall impression was reported by 89.0% for the autoinjector and 72.5% for the prefilled syringe.

          Conclusion

          Most patients with moderate-to-severe UC preferred to self-administer golimumab with the autoinjector over a prefilled syringe.

          Most cited references19

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          European evidence-based Consensus on the diagnosis and management of ulcerative colitis: Definitions and diagnosis.

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            Clinical assessment of pain, tolerability, and preference of an autoinjection pen versus a prefilled syringe for patient self-administration of the fully human, monoclonal antibody adalimumab: the TOUCH trial.

            Adalimumab is a therapeutic monoclonal antibody for SC administration by 2 single-use injection devices providing bioequivalent amounts of adalimumab: a ready-to-use, prefilled syringe and an integrated, disposable delivery system, the autoinjection Pen. Although pens have been shown to be preferred over syringes by patients requiring long-term SC administration of medications, there are no data on preference and pain in the use of biologics in patients with chronic inflammatory diseases. The aim of this study was to assess injection-site pain, tolerability, and patient preference of 2 delivery systems of adalimumab. Patients with rheumatoid arthritis were enrolled in a Phase II, multicenter, open-label, single-arm, sequential trial. Patients self-administered a standard dose of adalimumab 40 mg SC every other week at each of 3 monitored clinical visits: visit 1 (syringe), visits 2 and 3 (Pen). At each visit, patients rated their pain on an 11-point scale (0 = none to 10 = pain as bad as it could be) immediately after injection and 15-30 minutes after injection and provided their impressions of and preferences for each delivery system. Safety events were recorded throughout the study and 70 days after final study dose. Fifty-two patients were enrolled in the trial and completed all 3 visits (32 women, 20 men; mean [SD] age, 53.8 [12.1] years). Forty (76.9%) patients reported that the Pen was less painful than the syringe, 4 (7.7%) patients found the syringe to be less painful, and 8 (15.4%) patients had no preference. Patients had statistically significant reductions in injection-pain scores from visit 1 to visit 2 and from visit 1 to visit 3. No new safety signals or apparent differences regarding tolerability between the syringe and Pen were observed. In addition, 46 (88.5%) patients preferred the Pen, 3 (5.8%) preferred the syringe, and 3 (5.8%) had no preference. Overall, patients evaluated the Pen as easier to use (94.2%), more convenient (92.3%), requiring less time to inject (82.7%), and safer (88.5%). Patients experienced less pain self-administering adalimumab via the Pen and preferred it versus the syringe. Further, patients perceived the Pen to be easier to use and more convenient. Both delivery systems were generally well tolerated.
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              Adherence to anti-TNF therapy in inflammatory bowel diseases: a systematic review.

              Nonadherence to medications may affect disease outcomes. The aim of this article was to review methods of assessment, prevalence, and predictors of nonadherence to anti-tumor necrosis factor therapy in inflammatory bowel diseases (IBD).
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                Author and article information

                Journal
                Patient Prefer Adherence
                Patient Prefer Adherence
                Patient Preference and Adherence
                Patient preference and adherence
                Dove Medical Press
                1177-889X
                2018
                06 July 2018
                : 12
                : 1193-1202
                Affiliations
                [1 ]Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium, severine.vermeire@ 123456uzleuven.be
                [2 ]Department of Gastroenterology, AZ Groeninge, Kortrijk, Belgium
                [3 ]Department of Gastroenterology, CHWAPI, Tournai, Belgium
                [4 ]Department of Gastroenterology, Erasme Hospital, Brussels, Belgium
                [5 ]Department of Gastroenterology, CHC St Joseph, Liège, Belgium
                [6 ]Department of Gastroenterology, University Hospital CHU Sart Tilman, Liège, Belgium
                [7 ]Department of Gastroenterology, AZ St Lucas, Brugge, Belgium
                [8 ]Department of Gastroenterology, UCL St Luc, Brussels, Belgium
                [9 ]Department of Gastroenterology, AZ Damiaan, Oostende, Belgium
                [10 ]Department of Gastroenterology, OLV Hospital, Aalst, Belgium
                [11 ]Department of Gastroenterology, AZ Delta, Roeselare-Menen, Belgium
                Author notes
                Correspondence: Séverine Vermeire, Department of Gastroenterology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium, Tel +32 16 344 218, Fax +32 16 344 419, Email severine.vermeire@ 123456uzleuven.be
                Article
                ppa-12-1193
                10.2147/PPA.S154181
                6039065
                30013330
                c85fa200-d980-45ae-aaf4-f38556763077
                © 2018 Vermeire et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Medicine
                autoinjector,adherence,anti-tnf,subcutaneous injection,treatment,self-injection
                Medicine
                autoinjector, adherence, anti-tnf, subcutaneous injection, treatment, self-injection

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