Comparative acceptability of therapeutic maintenance regimens in patients with inflammatory bowel disease: results from the nationwide ACCEPT2 Study. - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Inflammatory Bowel Diseases Année : 2023

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

1 Service d'Hépatologie Gastro-entérologie [CHU Clermont-Ferrand]
2 3IHP - Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand]
3 M2iSH - Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte
4 Service de Gastro-entérologie [CHU Hôpital Nord - Marseille]
5 CIRI - Centre International de Recherche en Infectiologie
6 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
7 Hôpital Haut-Lévêque [CHU Bordeaux]
8 CHU Montpellier
9 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
10 Service d'Hépato-gastro-entérologie [CHRU Nancy]
11 INFINITE (Ex-Liric) - Institute for Translational Research in Inflammation - U 1286
12 CHU Nice - Centre Hospitalier Universitaire de Nice
13 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
14 Clinique Jules-Vernes [Nantes]
15 Clinique de l'Alma, Paris, France.
16 NuMeCan - Nutrition, Métabolismes et Cancer
17 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
18 CIC - Centre d'Investigation Clinique [Rennes]
19 EC2M3 - Early detection of Colon Cancer using Molecular Markers and Microbiota (EA 7375)
20 Elsan Pôle Santé République
21 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
22 CH Colmar
23 CHU Nantes - Centre Hospitalier Universitaire de Nantes
24 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
25 CHCB - Centre Hospitalier de la Côte Basque
26 Clinique du Parc
27 Clinique Internationale du Parc Monceau
28 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
29 Unité de Biostatistiques [CHU Clermont-Ferrand]
30 PERITOX - Périnatalité et Risques Toxiques - UMR INERIS_I 1
31 CHU Amiens-Picardie
Romain Altwegg
  • Fonction : Auteur
Laurianne Plastaras
  • 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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Dates et versions

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, 2023, 29 (4), pp.579-588. ⟨10.1093/ibd/izac119⟩. ⟨hal-03723436⟩
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