Background Impaired manual dexterity is common in patients (pts) with rheumatoid arthritis (RA), often resulting in difficulties with drug self-administration when using pre-filled syringes.1,2 Auto-injection devices (AIs) have been shown to provide a number of benefits, including reduced discomfort and greater ease of use compared with manual injections.2,3 A new certolizumab pegol (CZP) device was created, based on pt insights and capitalizing on the benefits of existing AIs.
Objectives To compare the usability of a new CZP AI with alternative anti-tumor necrosis factor (anti-TNF) devices (adalimumab, etanercept and golimumab) in patients with moderate to severe RA.
Methods Eligible pts had moderate to severe RA (fingers, hands and/or wrists affected) and no prior experience of using an AI for RA. Each pt tested 4 AIs (CZP, golimumab, etanercept and adalimumab) in a randomized order by performing a simulated self-injection on a training skin pad strapped to the upper thigh or lower abdomen. All identifications were removed from the AI devices and respective instructions for use. Pts were provided with instructions for use for each of the AIs, but were not trained on device use prior to testing. Following utilization of all four AIs, pts were asked to rank them in order of preference from 1–4 (1=the most preferred) and to provide feedback on their usability (easy to use, easy to start the injection, easy to tell when injection was finished and willingness to use).
Results Overall, 76 pts took part in this study. 67.1% pts ranked the CZP AI as their most preferred device; 23.7% ranked it as their second most preferred (Figure). The preference in the overall ranking of the CZP AI over each of the other devices was statistically significant (p<0.001). The majority of pts agreed, strongly agreed or very strongly agreed that the CZP AI was easy to use, easy to start the injection and that it was easy to determine when the injection was finished. Pts were significantly more willing to use the CZP AI compared with each of the other devices tested (p<0.001).
Conclusions In pts with moderate to severe RA, the CZP AI was the preferred choice compared to the golimumab, etanercept and adalimumab AIs, and was associated with a high level of patient satisfaction.
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Acknowledgement The authors acknowledge Costello Medical Consulting, funded by UCB Pharma, for writing and editorial assistance.
Disclosure of Interest B. Domanska Employee of: UCB Pharma, L. Peterson Employee of: UCB Pharma, I. Mountian Employee of: UCB Pharma, M. Schiff Grant/research support from: UCB Pharma, Consultant for: UCB Pharma