scholarly journals P621 Physician preferences for biologics (originator vs. biosimilar) for the treatment of ulcerative colitis in France, Germany and the UK

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S515-S516
Author(s):  
L Huynh ◽  
S Hass ◽  
B E Sands ◽  
M S Duh ◽  
H Sipsma ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Patient Preference ◽  
Treatment Options ◽  
Additional Treatment ◽  
Treatment Preference ◽  
Treatment Preferences ◽  
Clinical Settings ◽  
Good Tolerability ◽  
New Treatment ◽  
The Uk

Abstract Background Although originator biologics are effective therapies for patients with ulcerative colitis (UC), they can be costly and may not be widely available. Therefore, less expensive biosimilars have been developed and approved to treat and manage symptoms. In this new treatment landscape, UC-treatment preferences are unknown. Thus, this interim analysis aimed to characterise physician preferences for biologics for the treatment of UC in France, Germany and the UK. Methods As part of a broader chart review study, treatment preferences were also collected from participating gastroenterologists and general practitioners (GPs) in France, Germany and the UK who had treated patients (≥ 18 years) with moderate-to-severe UC who had received ≥ 1 UC-related biologic any time from 2014 to 25 October 2019. Descriptive statistics were used to describe the sample overall, and by physician speciality and treatment preference. Results Physicians (161 gastroenterologists; 57 GPs) were from different clinical settings in France (39.9%), Germany (28.4%) and the UK (31.7%). Overall, infliximab (33.0%) and adalimumab (32.1%) were selected more often as first treatment options than their biosimilars (17.0% and 9.6%, respectively). Gastroenterologists preferred biosimilars more frequently than GPs did (35.4% vs. 1.8%). More physicians who preferred biosimilars were from France (48.3%) than Germany (17.2%) or the UK (34.5%). In France and the UK, 93.8% of physicians who selected biosimilars worked in hospital settings; in Germany, 50.0% worked in clinics and 50.0% worked in practice settings with statutory and private patients. Physicians who preferred biosimilars treated more patients with UC in the preceding 12 months than those who preferred originators did (mean ± SD: 110.3 ± 113.9 vs. 94.0 ± 93.2). Although most physicians reported efficacy as a reason for biologic preference (93.6%), physicians who preferred originators were more likely to report good tolerability (73.8%) and patient preference (20.6%) and less likely to report affordability or availability (11.9%) than physicians who preferred biosimilars (63.8%, 10.3% and 44.8%, respectively). In patients who failed anti-TNF therapy, vedolizumab was the preferred treatment (78.9%), although this preference differed by speciality (gastroenterologists: 83.2%; GPs: 66.7%). Conclusion Originator biologics for treating patients with moderate-to-severe UC dominate the treatment landscape in Europe, driven primarily by efficacy, tolerability and patient preference. However, variations and differences in preferences by speciality and clinical setting may suggest a need to explore additional treatment options to manage disease symptoms among patients with UC.

The impact of a physician’s recommendation and gender on informed decision making: A randomized controlled study in a simulated decision situation

2020 ◽  
Author(s):  
Marie Eggeling ◽  
Anna Meinhardt ◽  
Ulrike Cress ◽  
Joachim Kimmerle ◽  
Martina Bientzle
Keyword(s):  
Decision Making ◽  
Cruciate Ligament ◽  
Treatment Options ◽  
General Information ◽  
Treatment Preference ◽  
Controlled Study ◽  
Treatment Preferences ◽  
Hypothetical Scenario ◽  
And Gender ◽  
The Impact

Objective: This study examined the influence of physicians’ recommendations and gender on the decision-making process in a preference-sensitive situation. Methods: N = 201 participants were put in a hypothetical scenario in which they suffered from a rupture of the anterior cruciate ligament (ACL). They received general information on two equally successful treatment options for this injury (surgery vs. physiotherapy) and answered questions regarding their treatment preference, certainty and satisfaction regarding their decision, and attitude toward the treatment options. Then participants watched a video that differed regarding physician’s recommendation (surgery vs. physiotherapy) and physician’s gender (female vs. male voice and picture). Afterward, they indicated again their treatment preference, certainty, satisfaction, and attitude, as well as the physician’s professional and social competence.Results: Participants changed their treatment preferences in the direction of the physician’s recommendation (P<.001). Decision certainty (P<.001) and satisfaction (P<.001) increased more strongly if the physician’s recommendation was congruent with the participant’s prior attitude than if the recommendation was contrary to the participant’s prior attitude. Finally, participants’ attitudes toward the recommended treatment became more positive (surgery recommendation: P<.001; physiotherapy recommendation: P<.001). We found no influence of the physician’s gender on participants’ decisions, attitudes, or competence assessments.Conclusion: This research indicates that physicians should be careful with recommendations when aiming for shared decisions, as they might influence patients even if the patients have been made aware that they should take their personal preferences into account. This could be particularly problematic if the recommendation is not in line with the patient’s preferences.

New Therapeutics for Ulcerative Colitis

2021 ◽  
Vol 72 (1) ◽  
pp. 199-213
Author(s):  
Robert P. Hirten ◽  
Bruce E. Sands
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Disease ◽  
Clinical Remission ◽  
Treatment Options ◽  
Treatment Modalities ◽  
Therapeutic Approaches ◽  
Stages Of Development ◽  
The Future ◽  
New Treatment ◽  
Novel Therapeutic

Ulcerative colitis (UC) is a relapsing and remitting inflammatory disease of the colon with a variable course. Despite advances in treatment, only approximately 40% of patients achieve clinical remission at the end of a year, prompting the exploration of new treatment modalities. This review explores novel therapeutic approaches to UC, including promising drugs in various stages of development, efforts to maximize the efficacy of currently available treatment options, and non-medication-based modalities. Treatment approaches which show promise in impacting the future of UC management are highlighted.

scholarly journals Novel Targets and Therapeutic Strategies for Promoting Organ Repair and Regeneration

Biomolecules ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 749
Author(s):  
Shanmugam Muruganandan ◽  
Michael Wigerius
Keyword(s):  
Stem Cell ◽  
Regenerative Medicine ◽  
Drug Administration ◽  
Treatment Options ◽  
Therapeutic Strategies ◽  
Clinical Settings ◽  
Special Issue ◽  
Organ Repair ◽  
Novel Targets ◽  
New Treatment

Strategies to create functional organs and tissues is of great interest for use in regenerative medicine in order to repair or replace the lost tissues due to injury, disease, as well as aging. Several new treatment options, including stem cell treatments and tissue-engineered substitutes for certain indications, have been approved by Food and Drug Administration (FDA) and are currently available. This special issue will cover new therapies and strategies that are currently being investigated under preclinical and clinical settings.

scholarly journals Management of Acute Severe Colitis in the Era of Biologicals and Small Molecules

2019 ◽  
Vol 8 (12) ◽  
pp. 2169
Author(s):  
Christine Verdon ◽  
Talat Bessissow ◽  
Peter L. Lakatos
Keyword(s):  
Ulcerative Colitis ◽  
Small Molecules ◽  
Patient Monitoring ◽  
Treatment Options ◽  
Medical Emergency ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
New Treatment ◽  
Acute Severe Colitis ◽  
Severe Colitis

Acute severe ulcerative colitis (ASUC) is a medical emergency which occurs in about 20%–30% of patients with ulcerative colitis during their lifetime, and does carry a mortality risk of 1%. The management of inflammatory bowel diseases has evolved with changes in objective patient monitoring, as well as the availability of new treatment options with the development of new biological and small molecules; however, data is limited regarding their use in the context of ASUC. This review aims to discuss the emerging data regarding biologicals and small molecules therapies in the context of ASUC.

Management of chronic myeloid leukemia in chronic phase (CML-CP) by American Hematology-Oncology Physicians (AHOP's): Diagnostic and treatment preferences after first-line imatinib (2010-2012).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7046-7046
Author(s):  
James M. Foran ◽  
Michael E. Williams ◽  
Joanne Willey ◽  
Mark R. Green
Keyword(s):  
Risk Stratification ◽  
Treatment Options ◽  
Chronic Phase ◽  
Kinase Domain ◽  
Subsequent Treatment ◽  
Treatment Preference ◽  
Treatment Preferences ◽  
Audience Response ◽  
Case Scenario ◽  
Double Blinded

7046 Background: In CML-CP there is perceived complexity in risk stratification at diagnosis, and in testing for BCR-ABL kinase domain mutation (KD mut, including T315I) at relapse. We sought to understand AHOP practices in the context of NCCN and European LeukemiaNet guidelines. Methods: Between 2010 and 2012, we studied time dependent practice preferences of n=1,335 AHOP’s using a proprietary, live, case-based market research tool. A core case scenario and variations based on available diagnostic & treatment options were constructed. Preference data were acquired using blinded audience response technology. All responses for each scenario were obtained contemporaneously prior to any display of summary respondent selections. All sources of research support were double blinded. AHOP's were presented with a scenario of 59-year old CML-CP patient, then indicated preferred management from up to 9 relevant available/emerging diagnostic or therapeutic options following relapse after 1st-line imatinib. Results: The majority of AHOP’s in 2012 either did not calculate (52%), or were unfamiliar (21%) with Sokal or Hasford risk stratification score. Diagnostic preferences following relapse from 2010-12 are noted in Table (distribution over time, p<0.0001). If T315I was then detected in scenario, we noted marked differences in subsequent treatment preference in 2012 vs. 2011, respectively: decreased AlloBMT (16% vs. 32%); & increased 2nd-line dasatinib (26% vs. 14%) or bosutinib (12% vs. 8%) vs. nilotinib (8% vs. 20%) despite lack of efficacy for each in T315I. Preference increased slightly for ponatinib (16% vs. 14%), but not for omacetaxine (2% vs. 6%). Conclusions: Most AHOP’s do not apply risk stratification. Increasing preference for KD mut panel testing at relapse conforms to guidelines, although not all AHOP’s test. Heterogeneity in T315I treatment suggests uncertainty or unfamiliarity with newer agents, and evidence-based efforts are needed to improve awareness. [Table: see text]

scholarly journals The impact of surgeon and patient treatment preferences in an orthopaedic trauma surgery trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Ada Keding ◽  
Helen Handoll ◽  
Stephen Brealey ◽  
Laura Jefferson ◽  
Catherine Hewitt ◽  
...  
Keyword(s):  
Patient Preference ◽  
Trauma Surgery ◽  
Treatment Preference ◽  
Patient Treatment ◽  
Treatment Preferences ◽  
Trial Conduct ◽  
Interaction Terms ◽  
Chi Squared ◽  
The Impact

Abstract Background Surgeon and patient treatment preferences are important threats to the internal and external validity of surgical trials such as PROFHER, which compared surgical versus non-surgical treatment for displaced fractures of the proximal humerus in adults. We explored the treatment preferences expressed by surgeons and patients in the trial and how these impacted on patient selection, trial conduct and patient outcome. Methods A series of exploratory secondary analyses of the PROFHER trial data were undertaken. We reviewed the extent of surgeon and patient treatment preferences (surgery or not surgery) at screening (n = 1250) as well as prior preference (including no preference) of randomised patients (n = 250), and assessed their impact on recruitment and adherence to follow-up and rehabilitation. Changes in treatment after 2 years’ follow-up were explored. Patient preference and characteristics associated with trial inclusion or treatment preference (t test, chi-squared test, Wilcoxon rank-sum test) were included as treatment interaction terms in the primary trial analysis of shoulder functioning (Oxford Shoulder Score, OSS). Results Surgeons excluded 17% of otherwise eligible patients based on lack of equipoise; these patients had less complex fractures (p < 0.001) and tended to be older (p = 0.062). Surgeons were more likely to recommend surgery for patients under 65 years of age (p = 0.059) and who had injured their right shoulder (p = 0.052). Over half of eligible patients (56%) did not consent to take part in the trial; these patients tended to be older (p = 0.022), with a preference for not surgery (74%; which was associated with older age, p = 0.039). There were no differential treatment effects (p value of interaction) for shoulder functioning (OSS) based on subgroups of patient preference (p = 0.751), age group (p = 0.264), fracture type (p = 0.954) and shoulder dominance (p = 0.850). Patients who were randomised to their preferred treatment had better follow-up rates (94 vs 84% at 2 years) and treatment adherence (90 vs 83% reported completing home exercises). Patients who were not randomised to their preferred treatment were more likely to change their treatment preference at 24 months (60 vs 26%). Conclusions The robustness of the PROFHER trial findings was confirmed against possible bias introduced by surgeon and patient preferences. The importance of collecting preference data is highlighted. Trial registration ISRCTN50850043. Registered on 25 March 2008.

scholarly journals Wet Combing for Head Lice: Feasibility in Mass Screening, Treatment Preference and Outcome

2002 ◽  
Vol 95 (7) ◽  
pp. 348-352
Author(s):  
R H Vander Stichele ◽  
L Gyssels ◽  
C Bracke ◽  
F Meersschaut ◽  
I Blokland ◽  
...  
Keyword(s):  
Primary Schools ◽  
Home Visit ◽  
Head Louse ◽  
Treatment Options ◽  
Treatment Preference ◽  
Treatment Preferences ◽  
Head Lice ◽  
Cure Rate ◽  
Louse Infestation ◽  
Head Louse Infestation

There is no scientific consensus on the best way to control head louse infestation in schoolchildren. A study was conducted to test the feasibility and acceptability of a screening campaign by wet combing and a community approach to head-louse control with home visits, and to explore parents’ treatment preferences and treatment outcomes. A non-controlled intervention (advice on treatment options offered to all positive children) was nested within an epidemiological prevalence study. All children in three primary schools in Ghent, Belgium, were invited to take part in screening by wet combing (n=677, 3–11 years). Positive children were offered structural treatment advice, a home visit on day 7, and a check by wet combing on day 14. 83% of the children were screened. The prevalence of active infestation (living moving lice) was 13.0% in school 1 and 19.5% in school 3. In school 2, prevalence of signs of active and past infestation was 40.7%. A home visit was made to 58% of the positive children. 85% of the positive children were screened again on day 14. Wet combing was the most widely used treatment, followed by chemical treatment and a combination of the two. In school 1 and 3 51% were cured, and in school 2 24% became nit-free. A wet combing screening campaign and a community-oriented approach to head-louse control is feasible though resource-intensive. The prevalence of head lice was high and the cure rate was low, with either topical treatments or wet combing.

scholarly journals Ulcerative colitis: STRIDE-ing beyond symptoms with new standards

2021 ◽  
Author(s):  
SW Tay ◽  
KKJ Teh ◽  
TL Ang ◽  
M Tan
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
Cancer Screening ◽  
Disease Activity ◽  
Burden Of Disease ◽  
Cancer Colorectal ◽  
Treatment Options ◽  
Colonic Neoplasms ◽  
High Definition ◽  
New Treatment

The landscape of ulcerative colitis has changed in the last two decades. Advancements in pharmacotherapeutics have heralded the introduction of new treatment options, with many agents in development. Better clinical outcomes are seen with tighter disease control, made possible with greater understanding of inflammatory pathways and their blockade with drugs. There has been a resultant shift in treatment targets, beyond symptoms to endoscopic and histological healing. Controlling the burden of disease activity also lowers the risk of developing colorectal cancer. Colorectal cancer screening now requires the use of dye-based agents and high definition colonoscopy to improve detection of colonic neoplasms.

scholarly journals P558 Medication Preference of 400 patients with mild to moderate Ulcerative Colitis

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S521-S522
Author(s):  
L Mackenzie-Smith ◽  
H Wüthrich ◽  
R Laoun
Keyword(s):  
Ulcerative Colitis ◽  
Patient Preference ◽  
Online Survey ◽  
Patient Adherence ◽  
High Strength ◽  
Treatment Changes ◽  
The Uk ◽  
Almost All ◽  
Physician Perception ◽  
Negative Attributes

Abstract Background Patient adherence to his/her medication is a major challenge in the successful management of any chronic disease and it is a major challenge in Ulcerative Colitis (UC). Patient adherence is thought to be closely related to patient preference of medication and formulation used. We wanted to investigate the patient preference between tablets and granules of mesalazine and compare it to the physician perception. Methods We conducted an online survey between November and December 2020 in 4 EU countries (France, Germany, Spain, and the UK). In addition to patients and physicians from these 4 countries, the questionnaire was also addressed to IBD nurses from the UK. Patients were included if they had mild or moderate UC. Results 400 patients, 160 physicians, 20 nurses participated in this survey. 68% patients were taking tablets and 32% granules. 62% of the patients who answered the survey admitted their preference for tablet while only 38% for granules (figure 1). 63.9% of the physician would prefer to prescribe tablets for their patients. Physicians stated that patients tend to be more adherent to tablets than granules (69% vs. 31%) and patients tend to find this the most convenient formulation. When patients were asked about some positive attributes of tablets, the highest agreement was with “good size, easy to see and handle” (7.6/10) while for granules “no problem to take granules in public” (8.4/10). When asked about some negative attributes of tablets, the highest agreement was with “I would like to take fewer each day” (6.1/10) and “I wish I could take fewer at a time” (5.4/10) while for granules “you have to drink a lot of liquid for them to go down” (6.6/10) and “I wish I could take fewer” (5.1/10). 50 patients were switched to tablets after trying granules first and 45 to granules after trying tablets. Treatment changes were initiated mainly by the physician (57% of the time). Patients switching to granules almost all agreed that they wanted to take fewer tablets each day (8.1/10). Patients switching to tablets complained about the need to drink a lot of water with granules (6.5/10) or to mix them with food (6.3/10). This is also reflected in the way patients take tablets (figure 2) or granules (figure 3). While 71% of the patients swallow the tablets whole only 35% of the patients swallow all the granules at once. 37% mix the granules with food or liquid, 20% divide the portions to be able to swallow them and 8% chew the granules. Asked about adherence, only 21% (85 patients) admitted taking less than 80% of prescribed medication. Conclusion The majority of the patients prefer the tablet formulation. A high strength tablet overcoming the pill burden could be a good solution to address patient expectations.

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