Abstract:OBJECTIVES: The real-world efficacy of the available therapies can be considerably influenced by the patient preferences. This study objective was to investigate treatment preferences for ulcerative colitis (UC) patients who receive advanced therapies in Greece.
METHODS: Between October 2023 and January 2024, adult patients who were members of Hellenic Society of Crohn’s disease’s and Ulcerative Colitis’ patients (HELLESCC) filled out a structured self-questionnaire. The survey questionnaire included, among others, treatment preferences related to mode of administration and clinical features of advanced therapies, namely tumor necrosis factor alpha (TNF-a) inhibitors, anti-integrins, anti-interleukins, and Janus kinase inhibitors. For clinical features, participants were presented with a list of therapeutic attributes that they were asked to rank in order of importance on a 100-point Likert scale. Based on the scores, the relative importance of each therapeutic attribute was estimated. Subgroup analyses within therapeutic classes were also explored.
RESULTS: Among the evaluated therapeutic attributes, preferences were driven by efficacy. Sustained remission over 2 years was ranked highest, with 17.2% relevance for the overall decision. The second most important attribute was 1-year remission rate (16.4%), followed by mucosal healing (15.3%), and time to first symptomatic improvement (14.3%). Lower importance was assigned to the frequency of serious adverse events (AEs) (13.2%), administration mode (12.7%), and frequency of non-serious AEs (10.9%). No major deviations occurred within treatment subgroups. Pertaining to mode of administration, patients preferred oral administration (41.9%), followed by subcutaneous (31%), and intravenous (13.5%). Fewer administrations and longer treatment intervals were rated higher. Among those receiving TNF-a inhibitors, anti-integrins and anti-interleukins, 40%, 43.8%, and 20% of patients would prefer an oral therapy, respectively.
CONCLUSIONS: In Greece, UC patients rated efficacy outcomes as the most important aspect of the treatment decision making process, followed by the frequency of serious AEs. Furthermore, patients showed a clear preference for orally administered advanced therapies.