Background/Purpose: Currently two modes of administration are available for biologic therapies used to treat rheumatoid arthritis (RA): subcutaneous injection (SQ) and intravenous infusion (IV).  Patient preference for mode of administration may be among the factors influencing choice of therapy.  The purpose of this study was to explore openness to and preference for biologic therapy among patients with RA prior to biologic initiation from the perspectives of both patients and prescribers.

Methods:  Data were collected online from both patients and prescribers through self-administered questionnaires.  Patients were U.S. adults (aged ≥18), diagnosed with RA, currently treated by a rheumatologist with disease modifying anti-rheumatic drugs (DMARDs), and with no history of biologic use but had discussed biologics with their physician.  Prescribers were board certified rheumatologists, practicing for 2-25 years, spent ≥50% of their time in a clinical setting seeing ≥50 RA patients per month, and were not government employees or employed by or consultants to pharmaceutical companies.  A total of 243 patients were recruited through the patient advocacy organization CreakyJoints (n=101) and a consumer panel (n=142); 103 prescribers were recruited through a physician panel.

Results: Among all study patients, 53% were open to both SQ and IV therapies, 16% were open only to SQ, 14% were open only to IV, and 16% were open to neither.  However, prescribers believed that 41% of patients are open to considering both SQ and IV therapies, 34% are open only to SQ, 13% are open only to IV, and 12% are open to neither.  When asked about preference for SQ vs. IV therapy, 22% of patients had no preference, while 49% preferred SQ and 28% preferred IV.  Prescribers believed that 31% of patients have no preference, while 52% prefer SQ and 16% prefer IV.  Patient openness to and preference for SQ vs. IV therapy was further influenced by frequency of administration, time to complete an infusion, and site of care.

Conclusion: More patients may be open to both SQ and IV biologic therapy and more patients may prefer IV biologic therapy than rheumatologists currently believe.  Rheumatologists are well positioned to guide the shared-decision making process with patients to ensure that patients are provided with information about all appropriate biologic therapy options and that patient preferences are considered when making prescribing decisions.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/openness-to-and-preference-for-biologic-therapy-among-patients-with-rheumatoid-arthritis-prior-to-biologic-initiation-patient-and-prescriber-perspectives/