Factors Contributing to the Preference of Korean Patients with Crohn's Disease When Selecting an Anti-Tumor Necrosis Factor Agent (CHOICE Study).
OBJECTIVE
Two comparable anti-tumor necrosis factor (TNF) agents with different routes of administration (intravenous [iv] infliximab [IFX] vs subcutaneous [sc] adalimumab [ADA]) are available for patients with Crohn's disease (CD) in Korea. This study aimed to identify the preferences of Korean CD patients for a specific anti-TNF agent and the factors contributing to the decision.


METHODS
A prospective survey was performed among anti-TNF-naive CD patients in 10 tertiary referral hospitals. A 16-item questionnaire addressed patient preferences and the factors contributing to the decision in favor of a particular anti-TNF agent. A logistic regression was conducted to assess predictive factors for ADA preference.


RESULTS
Overall, 189 patients (139 males; mean age, 32.47±11.71 years) completed the questionnaire. IFX and ADA were preferred by 63.5% (120/189) and 36.5% (69/189) of patients, respectively. The most influential reason for choosing IFX was 'doctor's presence' (68.3%, 82/120), and ADA was "easy to use" (34.8%, 24/69). Amid various clinicodemographic data, having a >60-minute travel time to the hospital was a significant independent predictive factor for ADA preference.


CONCLUSIONS
A large number of anti-TNF-naive Korean patients with CD preferred anti-TNFs with an iv route of administration. The reassuring effect of a doctor's presence might be the main contributing factor for this decision.
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Eun Soo
ES
Kim
Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Kyeong Ok
KO
Kim
Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Byung Ik
BI
Jang
Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
Chang Kyun
CK
Lee
Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
Hyo Jong
HJ
Kim
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Suwon, Korea.
Kang-Moon
KM
Lee
Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea.
You Sun
YS
Kim
Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea.
Chang Soo
CS
Eun
Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Sung-Ae
SA
Jung
Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
Suk-Kyun
SK
Yang
Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea.
Jun
J
Lee
Department of Internal Medicine, Inje University College of Medicine, Busan, Korea.
Tae-Oh
TO
Kim
Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
Yunho
Y
Jung
Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.
Geom Seog
GS
Seo
Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea.
Soon Man
SM
Yoon
D000068879:Adalimumab / Q000627:therapeutic use; D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001688:Biological Products / Q000627:therapeutic use*; D003424:Crohn Disease / Q000188:drug therapy* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D057240:Patient Preference / Q000523:psychology*; D011446:Prospective Studies; D056910:Republic of Korea; D011795:Surveys and Questionnaires; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D005765:Gastrointestinal Agents; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab
Adalimumab; Crohn disease; Infliximab; Preference