Bell CF, Lau M, Lee M, Poulos C. Insights into the choice between intravenous infusion and subcutaneous injection: physician and patient characteristics driving treatment in SLE. Clin Rheumatol. 2020 Jul 4. doi: 10.1007/s10067-020-05226-w.

INTRODUCTION/OBJECTIVES: Multiple modes of administration are available for systemic lupus erythematosus (SLE) treatments. This study examined patient and physician characteristics associated with the choice of weekly subcutaneous (SC) injection or monthly intravenous (IV) infusion for an unspecified SLE treatment.

METHODS: This was a cross-sectional, United States web-based survey using a direct elicitation, stated-preference methodology (HO-16-16706). 200 patients and 200 physicians were asked to choose between IV or SC administration in a hypothetical scenario. Pairwise and multivariate analyses estimated the odds ratio (OR) for the likelihood of choosing SC over IV for respondent characteristics.

RESULTS: Among patients, taking non-steroidal anti-inflammatory drugs increased the likelihood of choosing SC injection (OR: 3.884), whilst having SLE-related skin problems, a fear of needles or self-injection, and never needing help around the house decreased the likelihood (OR: 0.28, 0.13, 0.12, respectively; all p≤0.05). Among physicians, >95% recommended SC injection for patients who live or work far from an infusion center, prefer SC administration, and never or rarely miss medication doses. Physician characteristics including age and treatment practice also influenced choice.

CONCLUSIONS: Patient and physician characteristics influence choice of SC versus IV therapy for SLE. These findings might inform shared decision-making, which could lead to improved patient outcomes.

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