title: Are abatacept and tocilizumab intravenous users willing to switch for the subcutaneous route of administration? A questionnaire-based study.
abstract: Choosing the subcutaneous (SC) route of administration of abatacept and tocilizumab is more cost-effective than the intravenous (IV) route. The objective of this study was to examine patients' reasons for choosing to keep with their IV infusions or to switch to subcutaneous SC injections. This study was based upon a self-administered questionnaire given to consecutive rheumatoid arthritis patients treated with abatacept or tocilizumab. Patients were asked to express their opinions concerning reasons explaining why they chose to keep the IV route or switch to the SC route. A total of 201 questionnaires completed by 127 patients treated by tocilizumab and 74 by abatacept were analysed. Overall, 45.8% of the patients chose to keep the IV route of administration. Another ongoing SC treatment was noted more often in patients choosing the SC route (15.9 versus 4.3%, p < 0.05). Reasons guiding the choice of the SC route were concerns about repeated hospital day-care (72%), greater autonomy with SC injections (38.7%) and economic considerations (21.5%). Reasons associated with choosing to maintain the IV route were worries about a lack of follow-up (72.1%), the absence of medical assistance during the SC injection (61.2%), maintaining social relationships with other patients developed at the hospital (40.5%), lower frequency of injection (32.9%), fear of adverse events (27.7%) and fear of SC injections (17.9%). Patients reject the SC switch from the IV route of tocilizumab and abatacept mainly because of fears about the unknown SC route, while those who accept it find it more convenient.
authors.affiliation: Department of Rheumatology, Lille University, CHRU Lille, 2 avenue Oscar Lambret, 59000, Lille, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Desplats
authors.affiliation: Department of Rheumatology, Lille University, Saint Philibert Hospital, Rue du Grand But, 59462, Lomme Cedex, France. pascart.tristan@ghicl.net.|Saint-Philibert Hospital, Rue du Grand But, 59160, Lomme, France. pascart.tristan@ghicl.net.
authors.forename: Tristan
authors.initials: T
authors.lastname: Pascart
authors.affiliation: Department of Rheumatology, Amiens University, University Hospital of Amiens-Picardie, Hôpital Nord Place Victor Pauchet, 80054, Amiens Cedex 1, France.
authors.forename: Germain
authors.initials: G
authors.lastname: Jelin
authors.affiliation: Department of biomedical research, Lille University, Saint Philibert Hospital, Rue du Grand But, 59462, Lomme Cedex, France.
authors.forename: Laurène
authors.initials: L
authors.lastname: Norberciak
authors.affiliation: Department of Rheumatology, Lille University, CHRU Lille, 2 avenue Oscar Lambret, 59000, Lille, France.
authors.forename: Peggy
authors.initials: P
authors.lastname: Philippe
authors.affiliation: Department of Rheumatology, Lille University, Saint Philibert Hospital, Rue du Grand But, 59462, Lomme Cedex, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Houvenagel
authors.affiliation: Department of Rheumatology, Amiens University, University Hospital of Amiens-Picardie, Hôpital Nord Place Victor Pauchet, 80054, Amiens Cedex 1, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Goeb
authors.affiliation: Department of Rheumatology, Lille University, CHRU Lille, 2 avenue Oscar Lambret, 59000, Lille, France.
authors.forename: René-Marc
authors.initials: RM
authors.lastname: Flipo
mesh_terms: D000069594:Abatacept / Q000008:administration & dosage*; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D000069594:Abatacept; C502936:tocilizumab
keywords: Biologics; Patients’ preferences; Rheumatoid arthritis; Route of administration