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Article Dans Une Revue Inflammatory Bowel Diseases Année : 2022

Comparative acceptability of therapeutic maintenance regimens in patients with inflammatory bowel disease: results from the nationwide ACCEPT2 Study.

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Romain Altwegg
  • Fonction : Auteur
Laurianne Plastaras
  • Fonction : Auteur
Xavier Roblin
  • Fonction : Auteur

Résumé

BACKGROUND: Owing to growing number of therapeutic options with similar efficacy and safety, we compared the acceptability of therapeutic maintenance regimens in inflammatory bowel disease (IBD). METHODS: From a nationwide study (24 public or private centers), IBD patients were consecutively included for 6 weeks. A dedicated questionnaire including acceptability numerical scales (ANS) ranging from 0 to 10 (highest acceptability) was administered to both patients and related physicians. RESULTS: Among 1850 included patients (65.9% with Crohn's disease), the ANS were 8.68 ± 2.52 for oral route (first choice in 65.8%), 7.67 ± 2.94 for subcutaneous injections (first choice in 21.4%), and 6.79 ± 3.31 for intravenous infusions (first choice in 12.8%; P < .001 for each comparison). In biologic-na\"ive patients (n = 315), the most accepted maintenance regimens were oral intake once (ANS = 8.8 ± 2.2) or twice (ANS = 6.9 ± 3.4) daily and subcutaneous injections every 12 or 8 weeks (ANS = 7.9 ± 3.0 and ANS = 7.2 ± 3.2, respectively). Among 342 patients with prior exposure to subcutaneous biologics, the preferred regimens were subcutaneous injections (≥q2 week-intervals; ANS between 9.1 ± 2.3 and 8.1 ± 2.7) and oral intake once daily (ANS = 7.7 ± 3.2); although it was subcutaneous injections every 12 or 8 weeks (ANS = 8.4 ± 3.0 and ANS = 8.1 ± 3.0, respectively) and oral intake once daily (ANS = 7.6 ± 3.1) in case of prior exposure to intravenous biologics (n = 1181). The impact of usual therapeutic escalation or de-escalation was mild (effect size <0.5). From patients' acceptability perspective, superiority and noninferiority cutoff values should be 15% and 5%, respectively. CONCLUSIONS: Although oral intake is overall preferred, acceptability is highly impacted by the rhythm of administration and prior medication exposures. However, SC treatment with long intervals between 2 injections (≥q8 weeks) and oral intake once daily seems to be the most accepted modalities.
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hal-03723436 , version 1 (14-07-2022)

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Anthony Buisson, Mélanie Serrero, Laurie Orsat, Stéphane Nancey, Pauline Rivière, et al.. Comparative acceptability of therapeutic maintenance regimens in patients with inflammatory bowel disease: results from the nationwide ACCEPT2 Study.. Inflammatory Bowel Diseases, 2022, ⟨10.1093/ibd/izac119⟩. ⟨hal-03723436⟩
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