P4373 - Understanding Patient Preferences at the Time of Treatment Escalation to First Line Advanced Therapies in Ulcerative Colitis: A Discrete Choice Experiment in Five European Countries
Stefan Schreiber, MD1, Alissa Walsh, MD2, Peter Hur, PharmD3, Laura Panattoni, PhD4, Brett Hauber, 3, Grace Gahlon, 4, Josh Coulter, PhD3, Karolina Wosik, MSc, PhD5, Joseph C. Cappelleri, PhD, MPH6, Natalie Land, PhD4, Xiang Guo, PharmD, MS7, Anthony Buisson, MD, PhD8 1University Hospital, Kiel, Schleswig-Holstein, Germany; 2Translational Gastroenterology Unit, Oxford University Hospital, Oxford, England, United Kingdom; 3Pfizer Inc., New York, NY; 4PRECISIONheor, New York, NY; 5Pfizer Canada, Kirkland, PQ, Canada; 6Pfizer Inc., Groton, CT; 7Pfizer Inc., Collegeville, PA; 8University Hospital Estaing, Clermont Auvergne University, Inserm U1071, M2iSH, USC-INRA 2018, Clermont-Ferrand, Auvergne, France
Introduction: Patients with moderately to severely active ulcerative colitis (UC) escalating from conventional therapy (CT) to advanced therapy (AT) often consider several treatment factors. As more AT options become available, understanding the treatment preferences of AT naïve patients will enhance shared decision making with clinicians.
Methods: We conducted an online, cross-sectional survey of patients in the EU and UK with self-reported moderately to severely active UC who were diagnosed ≥ 3 months ago, had history of CT use (5-ASA, steroids, or immunomodulators), and did not report history of AT use. A discrete choice experiment (DCE) was used to quantify patient preferences for attributes associated with first-line AT for UC, including efficacy, safety, and mode and frequency of administration. Each patient completed 12 DCE choice tasks. Preference weights were estimated for all attribute levels using a random parameters logit model. Attribute relative importance (RI; range 0−100%) was calculated using the difference in preference weights between the most and least preferred level of each attribute to summarize the relative influence of each attribute on treatment choice.
Results: 514 patients, with a mean age of 44.0 years, were included. The majority had a university degree (73.0%), were employed full-time (53.7%), diagnosed with UC ≤ 5 years ago (76.1%), and had a mean (SD) Patient Modified Simple Clinical Colitis Activity Index score of 4.9 (3.3; score range 0−19; a score of < 3 is generally defined as remission). All DCE attributes factored into patient treatment decisions (Table: RI and preference weights). However, probability of remission at 1 year had the strongest influence on patients’ treatment preferences (RI: 46.2%) followed by 5-year risk of cancer (RI: 11.0%), annual risk of a major adverse cardiovascular event (RI: 10.9%) and time to symptom improvement (RI: 8.5%). Oral formulations with the same dose throughout were preferred over injection or infusion options (Table).
Discussion: In patients with moderate to severe UC and no reported history of AT use, probability of remission at 1 year, followed by 5-year risk of cancer, were the most important attributes influencing treatment choice, though all attributes tested had some impact. These findings will help to highlight to clinicians the trade-offs between efficacy, safety, and administration mode that patients make when considering AT choices. This is becoming increasingly important as more treatment options become available.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Stefan Schreiber: AbbVie – Consultant, Personal fees, Speakers Bureau. Amgen – Personal fees. Arena Pharmaceuticals – Consultant, Personal fees, Speakers Bureau. Biogen – Consultant, Personal fees, Speakers Bureau. Bristol Myers Squibb – Consultant, Personal fees, Speakers Bureau. Celgene – Consultant, Personal fees, Speakers Bureau. Celltrion – Consultant, Personal fees, Speakers Bureau. Eli Lilly and Company – Personal fees. Falk – Consultant, Personal fees, Speakers Bureau. Ferring Pharmaceuticals – Personal fees. Fresenius – Consultant, Personal fees, Speakers Bureau. Galapagos – Personal fees. Gilead – Consultant, Personal fees. Hikma Pharmaceuticals – Advisory Committee/Board Member, Consultant. I-MAB – Consultant, Personal fees. Janssen – Consultant, Personal fees, Speakers Bureau. Morphic – Personal fees. MSD – Consultant, Personal fees, Speakers Bureau. Mylan – Consultant, Personal fees. Novartis – Personal fees. Pfizer Inc – Consultant, Personal fees, Speakers Bureau. Protagonist – Consultant, Personal fees. Provention Bio – Consultant, Personal fees. Roche – Personal fees. Sandoz/Hexal – Personal fees. Shire – Personal fees. Takeda – Consultant, Personal fees, Speakers Bureau. Theravance Biopharma – Consultant, Personal fees. Ventyx – Consultant, Personal fees.
Laura Panattoni: AHRQ – Grant/Research Support. American Cancer Society – Grant/Research Support. Fred Hutchinson Cancer Research Center – Grant/Research Support. Gordon and Betty Moore Foundation – Grant/Research Support. ISPOR Planning Committe – Advisor or Review Panel Member. Microsoft – Grant/Research Support. NCI – Grant/Research Support. NIH – Grant/Research Support. Precision AQ – Consultant, Employee, Stock Options.
Stefan Schreiber, MD1, Alissa Walsh, MD2, Peter Hur, PharmD3, Laura Panattoni, PhD4, Brett Hauber, 3, Grace Gahlon, 4, Josh Coulter, PhD3, Karolina Wosik, MSc, PhD5, Joseph C. Cappelleri, PhD, MPH6, Natalie Land, PhD4, Xiang Guo, PharmD, MS7, Anthony Buisson, MD, PhD8. P4373 - Understanding Patient Preferences at the Time of Treatment Escalation to First Line Advanced Therapies in Ulcerative Colitis: A Discrete Choice Experiment in Five European Countries, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.