Abstract

Background:Several types of methotrexate (MTX) autoinjectors (AI) are currently marketed in rheumatoid arthritis (RA), yet comparative data are scarce.Objectives:Investigate respective perceptions of patients regarding two marketed forms of MTX AIviaa survey conducted by a global market research company.Methods:Patients with moderate to severe RA treated by one of the two forms of MTX AI were recruited. In each participating country (France, Ireland, United-Kingdom, Spain), the respective proportions of recruited patients were approximately aligned on local market shares. The two investigated devices were: A-AI/ The first MTX AI marketed in Europe: bigger size, with an activation button, without double injection sound-control, with a larger window; B-AI/ The second MTX AI commercialized in Europe: smaller and thinner size, without activation button, with double injection sound-control and a smaller window. Each patient was interviewed during 30 minutes on his or her satisfaction level with the currently used device. Then, they were presented the alternative AI and they could test it on skin-mimicking pads. After this step, the patients were interviewed on the alternative device.Results:100 patients were enrolled over one-month period (A-AI users, n=65; B-AI users, n=35). Overall, 61% of A-AI users reported that B-AI was “better” or “much better” whereas 43% of B-AI users judged A-AI as “better” or “much better”. When B-AI users were asked to evaluate convenience elements of A-AI, recognition of injection ending, general design and ease of use were the indicators that were the most poorly judged (60%, 54%, and 46% respectively). When A-AI users were cross-tested for B-AI, injection mode, general feeling, and ease of use were the three items providing the greatest satisfaction (80%, 77%, and 75%, respectively). When they were asked about the characteristics of their usual device, the button, the design of the device and discomfort associated with the injection were the most dissatisfactory elements (30%, 31%, 34% respectively). Also, 73% of A-AI users reported being interested in trying B-AI while 26% of B-AI users replied being so.Last, 95% of B-AI users declared being “very satisfied” or “totally satisfied”, with ease of use and recognition of injection ending being the most attractive items (94% and 95% of high or full satisfaction respectively).Conclusion:In this international cross-over survey, the newest autoinjector on the market, B-AI has shown to exhibit better reported outcomes with respect to ease of use and recognition of the end of the injection and other tested indicators.Treatment of patients with RA should aim at the best care and must be based on a shared decision between the patient and the rheumatologist.1In this scope, the shared decision making is permitted when the patient agrees with the choice of treatment (medication, administration route, device, etc.). Patient’s involvement in decision making is assumed to lead to improvement in health outcomes such as a better adherence to the treatment.2

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