Title:  Patient Satisfaction and Experience with Golimumab, Adalimumab, and Etanercept for the Treatment of Rheumatoid Arthritis, Psoriatic Arthritis, and Ankylosing Spondylitis

Background/Purpose: Golimumab (GLM), adalimumab (ADA), and etanercept (ETN) are subcutaneous (SQ) anti-TNF therapies available for the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). The purpose of this study was to explore satisfaction with effectiveness and injection experience with GLM, ADA, and ETN from the patient perspective.

Methods: In 2012, RA, PsA, and AS patients currently receiving SQ biologic therapy participated in telephone interviews. Patients rated satisfaction with current SQ therapy on a 7-point Likert scale (1= extremely dissatisfied and 7=extremely satisfied). Patients also described their most recent injection experience. Propensity weights were applied to adjust for differences in duration of therapy and past intravenous (IV) biologic use of GLM patients vs. ADA and ETN patients.

Results: A total of 69 GLM, 143 ADA, and 181 ETN patients participated in the study. Before adjustment, GLM patients had shorter duration of therapy than ADA and ETN patients (less than one year GLM: 51% vs. ADA: 21%, p<0.05 and ETN: 17%, p<0.05). Also, a greater proportion of GLM patients had prior IV biologic exposure (GLM: 41% vs. ADA: 14%, p<0.05 and ETN: 13%, p<0.05).When propensity weights were applied to adjust for differences in duration of therapy and prior IV biologic experience, GLM patients reported high satisfaction with effectiveness (6-7 on 7-point scale) at similar rates to ADA and ETN patients for prevention/treatment of condition (GLM: 55%, ADA: 55%, ETN: 56%), symptom relief (GLM: 45%, ADA: 51%, ETN: 57%), and time to onset (GLM: 44%, ADA: 42%, ETN: 50%). GLM patients reported lesser degrees of discomfort, pain, stinging, and burning during injection than ADA or ETN patients. 

Conclusion: Patient reported satisfaction with effectiveness is comparable among patients treated with GLM, ADA and ETN, and less discomfort, pain, burning, and stinging with injection is reported by GLM patients. Patient injection experience may be an important consideration in selection of biologic treatment. Future research should explore potential effects of patient injection experience on treatment adherence and patient outcomes.

Table: Most Recent Injection Experience (Adjusted using Propensity Weights)

*p<0.05 compared to GLM; †p<0.10 compared to GLM