https://orcid.org/0009-0000-8832-8112
Abstract
Purpose
Prefilled syringes (PFS) and various types of pens are available for subcutaneous injection of methotrexate (MTX) in patients with rheumatoid arthritis or moderate to severe psoriasis. A new MTX pen with modernized button-free autoinjection technology was developed as a successor to a button-activated pen (metoject®/metex® PEN). To assess the needs of users and the relevance of features of the new MTX autoinjector an international online survey was performed.
Methods
A structured questionnaire was distributed to physicians, nurses and patients in Germany, France, and the United Kingdom. Participants received illustrations and information about features of the new MTX autoinjector.
Results
In total, 189 rheumatologists, 111 dermatologists, 90 nurses, and 180 patients answered the questions. Specific reasons for a preference for the use of MTX pens over PFS could predominantly be assigned to the categories “dosing/administration” and “ease of use”. The first impression of the new MTX autoinjector was positive in 82% of physicians, 87% of nurses, and 76% of patients, respectively. The four most important features of the new MTX autoinjector were 2-step autoinjector mechanism (receiving a mean 14.1 to 18.1 chips of a total of 100 chips), small injection volume (9.7 to 11.7 chips), 10 different doses for dose flexibility (8.0 to 13.2 chips), and short injection time below 5 seconds (8.5 to 11.1 chips).
Conclusion
Arguments for the use of MTX pens as opposed to PFS predominantly refer to dosing/administration and ease of use. The new button-free MTX autoinjector combines a number of advantageous features identified by the international survey.
Plain Language Summary
Subcutaneous injection of methotrexate (MTX) is an option to treat patients with specific inflammatory diseases. A new MTX autoinjector with button-free activation of the injection and no need to build a skin fold was developed to address some of the reasons for non-adherence. The importance of specific needs of users as well as the relevance of features of the new MTX autoinjector are unknown. Therefore, a structured questionnaire was distributed to physicians, nurses and patients in Germany, France, and the United Kingdom. Illustrations and information about features of the new MTX autoinjector were distributed to the participants. The results of the study show that arguments for the use of MTX pens as opposed to prefilled syringes predominantly affect the categories dosing/administration and ease of use followed by safety/side effects. In addition, the study identified four main advantageous features of the new MTX autoinjector, ie simplicity due to the 2-step button-free autoinjector mechanism, the small injection volume, 10 different doses for dose flexibility, and the short injection time below 5 seconds.
Abbreviations
DMARDs, disease-modifying antirheumatic drugs; MTX, Methotrexate; PFS, prefilled syringes; RA, rheumatoid arthritis.
Data Sharing Statement
The datasets generated and analyzed during this international online survey are available from Aurum Research GmbH, Lauf a.d. Pegnitz, Germany on reasonable request.
Ethics Approval and Informed Consent
This study was an online market research and conducted according to the binding rules of quality and professional conduct set down by the EPhMRA (European Pharmaceutical Market Research Association) code of conduct, ESOMAR (European Society for Opinion and Market Research), the German association ADM (Arbeitskreis Deutscher Markt- und Sozialforschungsinstitute e.V.), and the legal obligations for data protection. It was also conducted in accordance to the ADM standards for interviewing physicians for the purposes of market and social research. An ethics committee approval was therefore not required. All participants provided informed consent before participating in the online survey due to their individual registration and access to the online panel site which includes their agreement to the terms and conditions of the M3 Global Research community such as anonymized reporting of the data.Citation29
Acknowledgments
The authors thank physicians, nurses and patients for participation in the online survey, Alexander Rummel (Aurum Research GmbH, Lauf a.d. Pegnitz, Germany) for his contribution to the design and the realization of this study, and Detlev Janssen (Med-i-Scene Concept GmbH, Weisendorf, Germany) for the medical writing assistance to prepare this manuscript which was funded by medac GmbH, Wedel, Germany.
Disclosure
Ulf Müller-Ladner served as a speaker/advisor for medac GmbH, Wedel, Germany. Andreas Erkens served as senior partner Aurum Research and advisor for medac GmbH, Wedel, Germany. The authors report no other conflicts of interest in this work.