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Systematic Assessment of Factors Influencing Preferences of Crohn's Disease Patients in Selecting an Anti‐Tumor Necrosis Factor Agent (CHOOSE TNF TRIAL)

Vavricka, Stephan R. MD1,2; Bentele, Nicoletta MD1; Scharl, Michael MD1; Rogler, Gerhard MD, PhD1; Zeitz, Jonas MD1; Frei, Pascal MD1; Straumann, Alex MD3; Binek, Janek MD4; Schoepfer, Alain M. MD5; Fried, Michael MD1; for the Swiss IBDnet and the Swiss IBD Cohort Study Group

doi: 10.1002/ibd.21888
Original Article: Original Clinical Articles

Background:: Infliximab (IFX), adalimumab (ADA), and certolizumab pegol (CZP) have similar efficacy in induction and maintenance of clinical remission in Crohn's disease (CD). Given the comparable nature of these drugs, patient preferences may influence the choice of the product. We aimed to identify factors that may contribute to CD patients' decision in selecting one anti‐tumor necrosis factor (TNF) agent over the others.

Methods:: A prospective survey was performed among anti‐TNF‐naïve CD patients. Prior to completion of a questionnaire, patients were provided with a written description of the three anti‐TNF agents, focusing on indications, mode of administration, side effects, and scientific evidence of efficacy and safety for each drug.

Results:: One hundred patients (47 females, mean age 45 ± 16 years, range 19–81) with an ileal, colonic, or ileocolonic (33%, 40%, and 27%, respectively) disease location completed the questionnaire. Based on the information provided, 36% of patients preferred ADA, 28% CZP, and 25% IFX, whereas 11% were undecided. The patients' decision in selecting a specific anti‐TNF drug was influenced by the following factors: ease of use (69%), time required for therapy (34%), time interval between application of the drug (31%), scientific evidence for efficacy (19%), and fear of syringes (10%).

Conclusions:: The majority of patients preferred anti‐TNF medications that were administered by subcutaneous injection rather than by intravenous infusion. Ease of use and time required for therapy were two major factors influencing the patients' selection of a specific anti‐TNF drug. Patients' individual preferences should be taken into account when prescribing anti‐TNF drugs. (Inflamm Bowel Dis 2012)

1 Department of Gastroenterology and Hepatology, University Hospital Zurich, Switzerland

2 Department of Gastroenterology and Hepatology, Triemlispital Zurich, Switzerland

3 Department of Gastroenterology and Hepatology, University Hospital Basel, Switzerland

4 Department of Gastroenterology and Hepatology, Kantonsspital St. Gallen, Switzerland

5 Department of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

Reprints: Stephan R. Vavricka, MD, Department of Gastroenterology and Hepatology, Triemlispital Zurich, Switzerland

(e‐mail: stephan.vavricka@usz.ch)

Reprints: Alain M. Schoepfer, MD, Department of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois / CHUV, 1011 Lausanne, Switzerland

(e‐mail: Alain.schoepfer@chuv.ch)

Received 7 August 2011; Accepted 15 August 2011

Published online 10 October 2011 in Wiley Online Library (wileyonlinelibrary.com).

Supported by research grants from the Swiss National Science Foundation (320000‐114009/1 to SRV, 3347CO‐108792 to the Swiss IBD Cohort) and a grant from the Zurich Center of Integrative Human Physiology (ZIHP).

Vavricka, Bentele, Schoepfer, and Fried contributed equally to this work.

© Crohn's & Colitis Foundation of America, Inc.
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