Patient preferences on rheumatoid arthritis second-line treatment: A discrete choice experiment of Swedish patients

Research output: Contribution to journalArticlepeer-review

Authors

  • Karin Bywall
  • Ulrik Kihlbom
  • Mats Hansson
  • eva baecklund
  • Jorien Veldwijk

Colleges, School and Institutes

External organisations

  • University of Uppsala, Uppsala, Sweden.
  • Uppsala Univ

Abstract

Background: Preference assessments of patients with rheumatoid arthritis can support clinical therapeutic decisions for including biologic and targeted synthetic medicines to use. This study assesses patient preferences for attributes of second-line therapies and heterogeneity within these preferences to estimate the relative importance of treatment characteristics and to calculate the minimum benefit levels patients require to accept higher levels of side effects. Methods: Between November 2018 to August 2019, patients with rheumatoid arthritis were recruited to a survey containing demographic and disease-related questions as well as a discrete choice experiment to measure their preferences for second-line therapies using biologics or Janus kinases inhibitors. Treatment characteristics included were route of administration, frequency of use, probability of mild short-term side effects, probability of side effects changing appearance, probability of psychological side effects, probability of severe side effects and effectiveness of treatment. Results: A total of 358 patients were included in the analysis. A latent class analysis revealed three preference patterns: (1) treatment effectiveness as the single most important attribute, (2) route of administration as the most important attribute, closely followed by frequency of use and psychological side effects and (3) severe side effects as the most important attribute followed by psychological side effects. In addition, disease duration and mild side effects influenced the patients’ choices. Conclusion: Respondents found either effectiveness, route of administration or severe side effects as the most important attribute. Patients noting effectiveness as most important were more willing than other patients to accept higher risks of side effects.

Bibliographic note

Funding Information: The Patient Preferences in Benefit-Risk Assessments during the Drug Life Cycle (PREFER) is a 5-year project that has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No. 115966. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and the European Federation of Pharmaceutical Industries and Associations (EFPIA). KR is supported by the Birmingham NIHR Biomedical Research Centre and is a member of the Research into Inflammatory Arthritis Centre Versus Arthritis and the MRC Versus Arthritis Centre for Musculoskeletal Ageing Research. Open Access funding provided by Uppsala University. Funding Information: KR is supported by the Birmingham NIHR Biomedical Research Centre and is a member of the Research into Inflammatory Arthritis Centre Versus Arthritis and the MRC Versus Arthritis Centre for Musculoskeletal Ageing Research. Publisher Copyright: © 2020, The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

Details

Original languageEnglish
Article number288
Number of pages10
JournalArthritis Research and Therapy
Volume22
Issue number1
Early online date19 Dec 2020
Publication statusPublished - 19 Dec 2020

Keywords

  • Discrete choice experiment, Patient preferences, Rheumatoid arthritis, Second-line treatment