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Most patients with RA comfortable with autoinjector for biologic
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Most patients with rheumatoid arthritis who used an autoinjector to administer Simponi were comfortable using the device and had better outcomes than patients who had someone else administer injections, according to results from part one of the GO-MORE trial.
The study included 3,280 international patients with rheumatoid arthritis (RA) who were diagnosed according to the American College of Rheumatology 1987 criteria and had active RA despite treatment with disease-modifying anti-rheumatic drugs (DMARDs). All patients had completed 6 months of treatment with Simponi (golimumab, Janssen), and none had previously been treated with a biological agent.
Disease activity was assessed using the erythrocyte sedimentation rate (DAS28-ESR). At baseline, mean disease duration was 7.6 years, mean DAS28-ESR was 5.97 and mean Health Assessment Questionnaire Disability Index (HAQ-DI) score was 1.44.
Patients were treated with subcutaneous golimumab every month and given the choice to use an autoinjector (SmartJect, Janssen) or receive the injection from a health care provider; 67.7% of patients chose to self-inject.
At the end of months 4 and 6, patients were asked about how easy the injector was to use, how much discomfort they experienced, how certain they were that the medication had been fully injected, how satisfied they were with the frequency of injection and about their overall impression of the self-injection experience.
Adherence rates to regular self-injection varied from 45% to 100% by country at 6 months, with the largest patient populations in Europe and Latin America, according to the researchers. Self-injection rates in Europe and Latin America at month 6 were 69.7% and 54%, respectively.
Patients who self-injected were more likely than patients who did not self-inject to have DAS28-ESR “good” or “moderate” responses (85.4% vs. 76.3%), DAS28-ESR remission (27.7% vs. 17.2%), DAS28-ESR low disease activity (42.7% vs. 28.1%), Simplified Disease Activity Index remission (15.7% vs. 11.4%) and HAQ-DI of 0.5 or less (40.4% vs. 32.0%).
Most patients at month 6 reported a preference to inject in the thigh (75.2%), followed by the abdomen (17.4%) and in the upper arm (7.2%), and the preferences were similar at month 4, according to the researchers. No differences in age, hand- or wrist-related disease activity, which hand was used to administer the injection or functional impairment were associated with injection site preference.
Patients who reported “no pain” or “no discomfort” were more likely to inject into their abdomen. At month 6, more than 90% of patients reported a favorable or very favorable experience with the use of the autoinjector; however, patients with functional impairment at baseline were less likely to report a favorable experience.
Of patients who gave a favorable rating to the use of the autoinjector at month 6, 55.5% had DAS28-ESR of 3.2 or greater, whereas patients who did not give a favorable rating (76.3%) were more likely to have DAS28-ESR greater than 3.2 at month 6.
No pain or mild pain was reported by more than 90% of patients, with more reports of no pain or mild pain in patients older than 58 years of age. More than 80% said the autoinjector was easy or extremely easy to use, according to the researchers. – by Shirley Pulawski
Disclosure: Schulze-Koops has received consultancy and speaking fees, and honoraria from MSD, AbbVie, Roche, Pfizer, and UCB. Please see the full study for a complete list of other authors’ financial disclosures.
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