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P463. Investigation on patient assessment of adalimumab self-injection treatment – a multicenter patient questionnaire Pearl survey

N. Kubokura1, F. Hirai2, K. Watanabe3, M. Esaki1, S. Nakamura4, Y. Yano2, N. Kamata3, M. Iimuro4, H. Yamagami3, T. Matsumoto1, T. Matsumoto4, T. Matsui2, 1Kyushu University, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Fukuoka, Japan, 2Fukuoka University Chikushi Hospital, Department of Gastroenterology, Fukuoka, Japan, 3Osaka City University Graduate School of Medicine, Department of Gastroenterology, Osaka, Japan, 4Hyogo College of Medicine, Department of Lower Gastroenterology, Hyogo, Japan

Background

Adalimumab (ADA), a self-injectable subcutaneous injection drug is expected to be highly convenient. In fact, reports on patient assessment of self-injection treatment are few. We aimed at elucidating the factors that affect the assessment and level of satisfaction of Crohn's disease (CD) patients on ADA self-injection treatment.

Methods

CD patients on ADA 40 mg/eow self-injection treatment at 4 university hospitals were the subjects of a questionnaire survey. The survey was approved by the ethics committee of each institution and informed consent was obtained from the patients prior to the questionnaire survey.

Results

A questionnaire was distributed and the responses collected from 124 patients (except for one patient who dissent the survey). The mean age was 36.3 years, and males accounted for 69%. Those with a history of IFX treatment were 53%, and the mean ADA treatment duration was 11.4 months. In the assessment conducted prior to initiation of the ADA treatment, 38% of the patients did not desire self-injection. In the assessment after the initiation of self-injection treatment, 75% of the patients stated that they were satisfied. Based on the status of the desire for self-injection prior to the initiation of the treatment, there was no significant difference in the level of satisfaction. Of the 66 patients with a history of IFX treatment, 68% felt that the IFX infusion time was a burden. Of the patients that felt the IFX infusion time was not a burden, 57% were satisfied with the ADA self-injection treatment. On the other hand, of the patients that felt the IFX infusion time was a burden, 87% were satisfied with the ADA self-injection treatment (P = 0.012). With regard to treatment efficacy, 63% of the patients were satisfied. Compared to patients with a history of IFX treatment, those without had a significantly higher level of satisfaction (P = 0.017). Of all the patients, 93% desired to continue the ADA self-injection treatment.

Conclusion

At the initiation of ADA treatment, many patients did not desire self-injection, however, after the initiation, a high patient evaluation rating was obtained, indicating that it is a useful form of treatment. In particular, patients that felt burdened by the IFX infusion time assessed the convenience highly. The self-injection was well tolerated on the whole and most of the patients desired to continue the treatment.