RESEARCH - Patient preferences in the choice of anti-TNF therapies in RA: RIVIERA

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Rheumatology Advance Access published online on November 17, 2009

Rheumatology, doi:10.1093/rheumatology/kep354

Patient preferences in the choice of anti-TNF therapies in rheumatoid

arthritis. Results from a questionnaire survey (RIVIERA study)

Salvatore Scarpato1, Marco Antivalle2, Ennio G. Favalli3, Francesca

Nacci4, Frigelli5, Francesca Bartoli4, Bazzichi6,

Giovanni Minisola7, Marco Matucci Cerinic4 and RIVIERA co-authors*

1Rheumatology Unit, M. Scarlato Hospital, Scafati (Sa), 2Rheumatology

Unit, L. Sacco University Hospital, 3Department of Rheumatology, G.

Pini Institute, Milano, 4Department of Internal Medicine, Division of

Rheumatology, University of Florence, Firenze, 5Rheumatology Unit,

Arcispedale S. M. Nuova, Reggio Emilia, 6Department of Internal

Medicine, Division of Rheumatology, University of Pisa, Pisa and

7Division of Rheumatology, ‘S. Camillo’ Hospital, Rome, Italy.

Abstract

Objective. To identify the determinants of anti-TNF-naive patients’

preferences for the route of administration of anti-TNF agents.

Methods. The study was carried out in 50 Italian rheumatology centres

(802 patients). All patients completed a 31-item questionnaire

addressing their perceptions of current treatment and the preferences

for treatment with anti-TNF agents. Statistical methods included

analysis of variance (ANOVA), t-test and chi-square test.

Results. The response rate to the questionnaire was 97.6%. At the time

of the survey, 310 (39.9%) patients were dissatisfied with current

treatments, owing to inefficacy, side effects and inconvenience of

administration. The i.v. and s.c. routes of administration were

preferred by 50.2 and 49.8%, respectively. No significant difference

was found in patients by gender, age, RA duration or number of drugs

used. Reasons for the choice of i.v. administration were the safety of

treatment at the hospital and the reassuring effect of physician

presence. The s.c. administration was chosen for the convenience of

treatment and in particular for home treatment. Patients dissatisfied

with current therapy due to side effects preferred s.c. administration

(P = 0.029), whereas patients choosing the i.v. route had slightly

higher scores on ‘today pain’ (P = 0.047) and ‘articular pain’ (P =

0.023) of the Rheumatoid Arthritis Disease Activity Index (RADAI).

Conclusions. Both i.v. and s.c. treatments were well accepted by

patients. However, treatment choice has to be discussed with patients,

as individual preference seems to be determined by personal attitudes

towards safety and convenience, by past experience and by the

perception of current disease status.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/kep354v1?papetoc

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