Satisfaction with Subcutaneous Golimumab and its Auto-Injector among Rheumatoid Arthritis Patients with Inadequate Response to Adalimumab or Etanercept

• Published in: The patient : patient-centered outcomes research 2018-06, Vol.11 (3), p.361-369
• Main Authors: Dehoratius, Raphael J., Brent, Lawrence H., Curtis, Jeffrey R., Ellis, Lorie A, Tang, Kezhen L.
• Format: Article
• Language: English
• Subjects: Adalimumab - therapeutic use; Adult; Aged; Antibodies, Monoclonal - therapeutic use; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - drug therapy; Etanercept - therapeutic use; Female; Health Administration; Health Economics; Humans; Immunotherapy; Injections, Subcutaneous; Male; Medicine; Medicine & Public Health; Middle Aged; Monoclonal antibodies; Original; Original Research Article; Patient Preference - psychology; Patient Preference - statistics & numerical data; Patient satisfaction; Pharmacoeconomics and Health Outcomes; Preferences; Public Health; Quality; Quality of Life Research; Rheumatoid arthritis; TNF inhibitors; Tumor necrosis factor-TNF
• ISSN: 1178-1653; 1178-1661
• DOI: 10.1007/s40271-018-0297-5

Background Patient perceptions of treatment success, including satisfaction/preference, may complement clinical efficacy assessments. Objective Our objective was to evaluate satisfaction with subcutaneous golimumab and its auto-injector in patients with rheumatoid arthritis (RA) and an inadequate adalimumab/etanercept response. Methods In the multicenter, assessor-blinded GO-SAVE study, 433 patients with active RA (28-joint Disease Activity Score incorporating erythrocyte sedimentation rate [DAS28-ESR] ≥ 3.6 and six or more swollen and six or more tender joints) despite methotrexate and past adalimumab/etanercept treatment received open-label subcutaneous golimumab 50 mg every 4 weeks (q4w) through week 12. Week 16 responders (DAS28-ESR improvement from baseline > 1.2 and score ≤ 3.2) continued therapy through week 52; nonresponders were randomized (1:2) to double-blind subcutaneous golimumab 50 mg q4w or intravenous golimumab 2 mg/kg [weeks 16, 20, every 8 weeks (q8w)]. Patients rated satisfaction with their injection experience on a 5-point scale (1 = very dissatisfied; 5 = very satisfied) at screening, week 8 (all enrolled patients), and week 44 (for patients continuing open-label subcutaneous golimumab 50 mg q4w). Discomfort, pain, stinging, burning, and redness related to injection were assessed (none, mild, moderate, severe). Results Similar proportions of patients ( N  = 433) had most recently received adalimumab (50.3%) or etanercept (49.7%) prior to golimumab. Overall satisfaction (somewhat/very) with the golimumab injection experience was reported by 84.4% of patients at week 8 versus 63.4% of patients who were satisfied with prior adalimumab/etanercept. Patients receiving open-label subcutaneous golimumab through week 44 ( N  = 75) reported much less discomfort (60.9%), redness (60.9%), pain (59.4%), stinging (67.2%), and burning (65.6%) with the golimumab injection than with their previous tumor necrosis factor antagonist medication injection. Conclusion Most patients with RA receiving golimumab following adalimumab/etanercept inadequate response were satisfied with their overall golimumab experience, including its auto-injector versus their previous injection device. Clinical trials.gov NCT01004432; EudraCT 2009-010582-23.