Nurse and Patient Perceptions and Preferences for Subcutaneous Autoinjectors for Inflammatory Joint or Bowel Disease: Findings from a European Survey

Abstract

Introduction Imraldi™ is a biosimilar of the anti-tumor necrosis factor (TNF) monoclonal antibody adalimumab and was recently approved in Europe for the treatment of various inflammatory conditions. Imraldi is administered via an autoinjector device that features distinct design attributes compared with other biologic TNF inhibitor autoinjectors, such as the Humira (adalimumab) Pen® and Enbrel® (etanercept) MyClic® Pen were developed by the relevant pharmaceutical companies. The aim of this study was to evaluate patients’ and nurses’ preferences for the Imraldi versus Humira or Enbrel MyClic autoinjectors in the UK and Germany. Methods Patients with inflammatory joint or bowel disease and nurses with experience in educating patients with these conditions on self-injection participated in two survey studies, the first comparing the Imraldi and Humira autoinjectors and the second comparing the Imraldi and Enbrel MyClic autoinjectors. Results Overall, 101 nurses (UK, n = 50; Germany, n = 51) and 151 patients (UK, n = 90; Germany, n = 61) participated in both studies. In the first study, 85% of nurses and 78% of patients preferred the Imraldi autoinjector over the Humira autoinjector ( P < 0.001); in the second study, 86% of nurses and 79% of patients preferred the Imraldi autoinjector over the Enbrel MyClic autoinjector ( P < 0.001). Top reasons for preferring the Imraldi autoinjector included ease of use, ease of grip, and its button-free initiation mechanism. Most nurses indicated they would recommend the Imraldi autoinjector over the Humira and Enbrel MyClic autoinjectors, and most patients indicated they would choose the Imraldi autoinjector over the Humira and Enbrel MyClic autoinjectors to continue treatment. Conclusion Nurses and patients in the UK and Germany preferred the Imraldi autoinjector over both the Humira and Enbrel MyClic autoinjectors, which may be a consideration, along with other factors, for treatment decisions in the management of patients with inflammatory joint or bowel disease. Funding Biogen International GmbH. Electronic supplementary material The online version of this article (10.1007/s40744-019-0144-8) contains supplementary material, which is available to authorized users.

A Patients' Perspective Towards the Injection Devices for Humira® and Imraldi® in a Nationwide Switching Program

“…To our knowledge, no comparable study has been conducted on a nationwide basis. A survey conducted among a selected group of patients and nurses in Germany and the United Kingdom focused on the patients' preference for using Imraldi R pen versus Humira R or Enbrel R (etanercept) pens (5). Fenwick and colleagues demonstrated that most of their patients (78%) preferred to use the Imraldi R pen.…”

“…In 2018 the Humira R patent expired in Europe, and its biosimilar Imraldi R was launched. Although Imraldi R has been shown to have comparable quality, efficacy and safety as Humira R (5,6), there is a difference among the two devices used to self-administration of the drugs. Both Humira R and Imraldi R are supplied with pre-filled pens containing 40 mg of the active substance adalimumab, but Humira R contains 0.4 mL of a sterile solution while Imraldi R contains 0.8 mL.…”

<p>Patients’ Perceptions and Preferences Regarding Two Different Forms of Methotrexate Autoinjectors for Moderate to Severe Rheumatoid Arthritis: A European Crossover Survey</p>

“…These results also confirmed those of other studies performed with biosimilar-autoinjectors that showed the preference of RA patients for injection mode with no push button and/or system with feedback after completion of injection. [12][13][14] Autoinjectors are designed to improve adherence, but self-injection is associated with a number of challenges including needle phobia, deformity and pain in the hands and fingers that can limit grip strength and severely impact the capacity of the patient to hold the device confidently and/or activate the injection correctly. 15 In clinical practice, although most patients prefer an autoinjector with no push button and appreciate to be informed of the end-ofinjection (as supported by the present survey and other studies), each patient would present with their own challenges.…”

Medication safety risks to be managed in national implementation of automatic substitution of biological medicines: a qualitative study

“…Substitution may also be inappropriate if the patient will not be able to use the new product due to physical handicap or other relevant reasons. Nevertheless, the patients and healthcare providers may also consider a new device as easier to use 55–57. It is important that the physicians will have to present a clinically sound justification if they wish to prohibit the substitution.…”