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P354. Satisfaction and concerns about anti-TNF alpha therapy in Crohn's disease - the patient's perspective in a Portuguese population

C. Fernandes, T. Pais, I. Ribeiro, R. Pinho, A.P. Silva, A. Rodrigues, L. Proença, L. Alberto, J. Carvalho, Gaia Hospital, Gastroenterology, Vila Nova Gaia, Portugal

Background

Anti-TNF alpha therapy is a common option in Crohn's disease treatment. However, there is still no consensus about its interruption in patients with remission. Few studies have evaluated patient's perspective about anti-TNF alpha therapy, namely the importance of a finite therapy.

Aims: To evaluate patient's opinion about the importance of a finite anti-TNF alpha therapy; to assess patients' satisfaction about the administration scheme of its current anti-TNF alpha therapy and to compare it to the alternative regimen.

Methods

Crohn's disease patients treated with anti-TNF alpha therapy (infliximab and adalimumab) during 2013 were studied. A questionnaire was performed by a single physician (CF). Data evaluated: (1) the effect of anti-TNF alpha therapy in daily routine; (2) the administration scheme and its comparison with the alternative and (3) the relevance of a finite therapy.

Results

43 patients were selected and of these 38 agreed to answer the questionnaire (55.3% female; mean age: 38.3 [±10.7] years); (1) infliximab group: 21 patients (mean age: 40.4 [±10.4] years; 57.1% male); Median follow-up since the beginning of anti-TNF alpha therapy: 21.0 [26.1] months; 57.1% of the patients were employed, and from these 58.3% needed to miss work days to comply with the treatment; patients rated the beneficial effect of anti-TNF therapy as 8.4 [in a scale of 0–10]) and the comfort of the administration scheme as 8.1 [0–10]. 52.7% patients declared that they would prefer administration scheme of the alternative therapy. (2) adalimumab group: 17 patients (mean age 35.6 [±10.9] years; 70.6% female); Median follow-up since the beginning of anti-TNF alpha therapy: 13.0 [±16.3] months; 47.1% patients were employed but adalimumab didn't have any impact in their daily activities; patients rated the beneficial effect of anti-TNF alpha therapy as 8.6 [0–10]) and the comfort of the administration scheme as 7.6 [0–10]; however only 35.3% would prefer to change to the alternative scheme; (3) the hypothesis of a finite therapy was highly valued in our sample (total: 8.3; infliximab group 8.3; adalimumab group 8.4 [0–10]) and almost half of the patients (47.3%) admitted to fear some therapy adverse effects.

Conclusion

In our sample: (1) patients are globally satisfied with their current anti-TNF alpha therapy scheme of administration; (2) the majority of patients under infliximab admitted will to change their administration scheme; (3) patients considered the possibility of a finite anti-TNF alpha therapy a very important issue; (4) almost half of the patients admitted to fear some adverse effects of anti-TNF alpha therapy.