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Comparative Acceptability of Therapeutic Maintenance Regimens in Patients With Inflammatory Bowel Disease: Results From the Nationwide ACCEPT2 Study.

Anthony Buisson 1 Mélanie Serrero 2 Laurie Orsat Stéphane Nancey 3 Pauline Rivière 4 Romain Altwegg 5 Laurent Peyrin-Biroulet 6, 7 Maria Nachury 8 Xavier Hébuterne 9 Cyrielle Gilletta 10 Mathurin Flamant 11 Stéphanie Viennot 12 Guillaume Bouguen 6, 7 Aurélien Amiot 13 Stéphane Mathieu 14 Lucine Vuitton 15 Laurianne Plastaras 16 Arnaud Bourreille 17 Ludovic Caillo 18 Félix Goutorbe 19, 20 Guillaume Pineton de Chambrun 21 Alain Attar 22 Xavier Roblin 23 Bruno Pereira 24 Mathurin Fumery 25, 26 
Abstract : 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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https://hal-u-picardie.archives-ouvertes.fr/hal-03723436
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Soumis le : jeudi 14 juillet 2022 - 17:24:08
Dernière modification le : vendredi 5 août 2022 - 11:25:48

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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, pp.izac119. ⟨10.1093/ibd/izac119⟩. ⟨hal-03723436⟩

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