Patient Preferences for Treatment Attributes in Inflammatory Bowel Disease: A Discrete Choice Experiment Among Patients in Five Non-Western Countries.

Abstract

Introduction: Understanding patient preferences is important for facilitating informed decision-making in managing patients with inflammatory bowel disease (IBD). This study explored the preferences of patients with Crohn's disease (CD) and ulcerative colitis (UC) regarding advanced therapy treatment attributes in five non-Western countries: Argentina, Australia, Brazil, Saudi Arabia and Taiwan.

Methods: Adult patients with self-reported CD or UC treated for ≥ 6 months participated in this cross-sectional online survey. A discrete choice experiment assessed the relative importance of treatment attributes using conditional logit models. The primary objective was to estimate partworth utilities across the five countries (overall population).

Results: Overall, 706 patients with CD and UC (n = 353 each) completed the survey (mean age 36.8 and 37.7 years; female 47.9% and 47.6%; mean disease duration 4.5 and 4.6 years, respectively). For patients with CD, the rate of long-term remission on maintenance therapy (LTREM) was the most preferred treatment attribute (32.5%), followed by the rate of 1-year remission (25.7%), routes of administration (RoAs; 24.6%) and risk of serious adverse events (AEs) (11.5%) and mild AEs (5.8%). For patients with UC, the rate of corticosteroid-free remission after 1 year was the most important attribute (30.8%), followed by RoAs (27.4%), rate of mucosal healing after 1 year (16.1%), LTREM (14.9%) and risk of serious AEs (10.0%) and mild AEs (0.8%). Patients in both groups considered abdominal pain as the symptom most impacting their quality of life. Approximately half of the patients (CD 49.3%; UC 50.5%) exposed to advanced therapy indicated that they would have preferred to start advanced therapy earlier.

Conclusion: Patients with IBD from non-Western countries prioritised advanced treatment attributes such as efficacy outcomes and RoAs, although treatment preferences varied between patients with CD and UC. Shared decision-making between patients and physicians regarding advanced therapy choice and timing should occur throughout the treatment journey.