Background/Purpose: Treatment options in rheumatoid arthritis (RA) have expanded significantly over recent years, and several agents are now available for oral, subcutaneous (SC) or intravenous (IV) use. Route of administration may be an important differentiator between drugs that are used to treat RA, especially if patient preferences influence adherence and outcomes of therapy. The purpose of this study was to investigate patient preferences for attributes associated with RA treatments in Lebanon.

Methods: A national, multicenter, cross-sectional patient survey was designed to collect data across several private and university hospital clinics on the typical RA patient profile. Participants were asked about their use of RA therapies, preferences for oral, IV or SC therapy and their physician’s role in their decision-making process. Data were analyzed using the Chi-square test and Mann-Whitney test.

Results: A total of 693 patients, consecutively recruited over a fixed period of 3 months, completed the survey. The median patient age range was 51‒60 years (28.7%). The majority of respondents were female (83%). Over 81% of patients had health coverage. A large proportion (80%) of patients had established RA, with only 3% having early RA. One-third of patients (34.2%) were in DAS28 remission, while 32.9% had a DAS28 score of 3.3‒5.1. Oral was the most common route of DMARD administration. Almost 60% of patients received medication by this route only, with a further 27% using the oral route in combination (with either IV or SC). Patient route preference mirrored this trend with almost two-thirds of patients (64%) preferring the oral route (Table 1). There was a significant association between route of administration and therapy preference. Patients with an IV route had a similar preference for IV therapy (43%) and oral therapy (40%). SC patients also had split preferences, with 41% preferring oral therapy and 38% SC therapy. Those with an oral route overwhelmingly preferred oral therapy (82%) (Table 2). The physician’s advice was cited as the main influence when choosing a treatment, with over half (53%) of patients giving this as their top choice.

Conclusion: The majority (64%) of patients preferred the oral route of administration. There was a strong correlation between the route of administration in use and the preference. The patients’ preferences of administration were influenced mainly by the physician, followed by experience with current or previous treatments. Understanding patient preferences may help to inform provider and payer decisions in treatment selection that may enhance patient adherence to therapy.