Background Rituximab for rheumatoid arthritis (RA) has been recently approved by the EMA to be administered over a shorter time (from 3.25 hours to 2 hours) after the first infusion. The label update was based on the safety study of a faster infusion of rituximab that found that rituximab was well tolerated when administered over a 2-hour period for the 2nd and subsequent infusions1.
Objectives To quantify patients' preference for receiving rituximab over a 2-hour infusion vs a 3.25-hour infusion.
Methods We conducted a discrete-choice experiment with 901 patients with moderate to severe RA. Patients were presented with a series of treatment-choice questions2. Each hypothetical treatment included the following attributes: mode of administration, treatment duration, treatment frequency, risk of adverse events (mild or severe) and response rate. Mixed-logit methods were used to estimate the relative importance of each attribute. Results were used to calculate the predicted probability of choosing rituximab with different infusion times (RA drug, administered as an infusion, requiring 2 infusions 2 weeks apart every 24 weeks) from among 8 possible RA treatment options. Indifference curves were generated to compare patient preference between duration and frequency of rituximab treatment.
Results When infusion time was 3.25 hours, the predicted choice probability for rituximab was 14.1% (95% CI, 11.4% to 16.8%). When infusion time was 2 hours, the predicted choice probability was 17.9% (95% CI, 15.6% to 20.2%). Indifference curves are shown in the figure. Reducing duration from 3.25 hours to 2 hours has a larger effect on patient's preference than reducing the frequency of a 3.25-hour infusion from quarterly to twice per year.
Conclusions In a discrete-choice model, rituximab had a higher predicted choice probability when administered over a shorter period of time. Patients' preference for a shorter administration time was higher than their preference for less frequent administrations. A shorter infusion time has the potential to improve patient satisfaction with treatment administration.
Pritchard CH, et al. Safety of infusing rituximab at a more rapid rate in patients with rheumatoid arthritis: results from the RATE-RA study. BMC Musculoskelet Disord. 2014;15:177.
Poulos C, et al. Patients' willingness to trade off between the duration and frequency of rheumatoid arthritis treatments. Arthritis Care Res. 2014;66:1008-1015.
Disclosure of Interest B. Hauber Employee of: RTI Health Solutions, K. Raimundo Employee of: Genentech, S. Zlotnick Employee of: Genentech, C. Poulos Employee of: RTI Health Solutions, D. Borie Employee of: Genentech, A. Turpcu Employee of: Genentech