title: Factors influencing the patient evaluation of injection experience with the SmartJect autoinjector in rheumatoid arthritis.
abstract: OBJECTIVE
  To evaluate factors influencing injection patterns and patient evaluations of an autoinjector device in biologic-naïve patients beginning golimumab (GLM) treatment.
  
  
  METHODS
  GO-MORE was an open-label, multinational, prospective study in patients with active rheumatoid arthritis (RA) (28-joint disease activity score based on erythrocyte sedimentation rate [DAS28-ESR] ≥3.2). Patients injected 50 mg subcutaneous GLM once monthly for 6 months. Patients reported use preferences and autoinjector evaluations by questionnaire. Responses were analysed descriptively. Effects of patient variables were evaluated with chi-square tests or t-tests.
  
  
  RESULTS
  Of 3,280 efficacy-evaluable patients, 67.7% self-injected with the autoinjector. Compared with patients who self-injected, patients who had someone else administer injections had greater baseline disease activity (e.g., DAS28-ESR 5.84 vs. 6.23, respectively), but not more tender/swollen joints in hands/wrists. Month 6 efficacy was greater for patients who self-injected. In those who self-injected, injection site (thigh [75.2%; 1,563/2,077], abdomen [17.4%; 363/2,077], upper arm [7.2%; 151/2,077]) was not associated with wrist swelling or tender/swollen joints in the hand used for injection. Autoinjector ratings were similar across injection sites, yet less pain/discomfort was associated with abdomen injection. Patient autoinjector ratings were favourable overall (e.g. ease of use, pain). Patients with baseline functional impairment had slightly less favourable ratings.
  
  
  CONCLUSIONS
  Biologic-naïve patients who self-injected had less baseline disease activity and higher response rates than patients who did not self-inject. Although patients prefer to inject in the thigh, injection in the belly may be less painful. Most patients who self-injected had favourable autoinjector evaluations; patients with functional impairment had slightly less favourable ratings.
authors: Division of Rheumatology, Department of Internal Medicine IV, University of Munich, Munich, Germany.
authors: Hendrik
authors: H
authors: Schulze-Koops
authors: University of L'Aquila, L'Aquila, Italy.
authors: Roberto
authors: R
authors: Giacomelli
authors: Ortopedyczno-Rehabilitacyjny Szpital Kliniczny, Poznań, Wielkopolskie, Poland.
authors: Wlodzimierz
authors: W
authors: Samborski
authors: University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors: Simona
authors: S
authors: Rednic
authors: Medical University of Innsbruck, Innsbruck, Austria.
authors: Manfred
authors: M
authors: Herold
authors: Merck & Co., Inc., Whitehouse Station, NJ, USA.
authors: Ruji
authors: R
authors: Yao
authors: MSD Italy, Rome, Italy.
authors: Marinella
authors: M
authors: Govoni
authors: MSD Belgium, Brussels, Belgium.
authors: Nathan
authors: N
authors: Vastesaeger
authors: Merck & Co., Inc., Whitehouse Station, NJ, USA.
authors: Haoling H
authors: HH
authors: Weng
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D001331:Automation; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D004867:Equipment Design; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D057240:Patient Preference; D010361:Patients / Q000523:psychology*; D011446:Prospective Studies; D012646:Self Administration; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013594:Syringes; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; C529000:golimumab