A real-world, multi-site, observational study of infusion time and treatment satisfaction with rheumatoid arthritis patients treated with intravenous golimumab or infliximab

Figures & data

Table 1. Time-related study variable definitions.

Study variable	Definition
Clinic visit duration	Time from patient’s check-in at site to verbal discharge
Medication preparation time	Sum of the total time to calculate drug dose; time to gather supplies for infusion; time to reconstitute product (IFX only); time to visually inspect solution; time to dilute the product; time to transport the bag to the IV pump
Patient preparation time	Time from patient entry to the infusion area to attachment of medication bag to the IV line
RA medication infusion time	Time of RA medication drip initiation to confirmation of RA medication drip conclusion
RA medication infusion stop time	Sum of time RA medication was stopped during the RA medication infusion time
Infusion process time	Sum of the total time for RA infusion medication preparation; time for patient preparation; time required for RA medication infusion

Abbreviations. IFX, infliximab; IV, intravenous; RA, rheumatoid arthritis.

Table 2. Patient demographics by treatment group.

Characteristic	Overall (n = 150)	GLM-IV (n = 72)	IFX (n = 78)	p-value
Age, years				.0105
Mean (SD)	63 (13.5)	61 (14.8)	66 (11.6)
Median (range)	66 (22–86)	64 (24–85)	67 (22–86)
Gender, n (%)				.2204
Male	30 (20.0)	11 (15.3)	19 (24.4)
Female	120 (80.0)	61 (84.7)	59 (75.6)
Race, n (%)				.0618
Caucasian	133 (88.7)	65 (90.3)	68 (87.2)
Black or African American	8 (5.3)	6 (8.3)	2 (2.6)
Asian/Pacific Islander	1 (0.7)	0 (0.0)	1 (1.3)
American Indian or Alaska Native	0 (0.0)	0 (0.0)	0 (0.0)
Other	8 (5.3)	1 (1.4)	7 (9.0)
Prefer not to answer	0 (0.0)	0 (0.0)	0 (0.0)
Ethnicity, n (%)				.0581
Hispanic or Latino	11 (7.3)	2 (2.8)	9 (11.5)
Not Hispanic or Latino	139 (92.7)	70 (97.2)	69 (88.5)
Weight				.6846
Mean (SD)	84.6 (23.88)	83.8 (24.18)	85.4 (23.73)
Median (range)	82.0 (33–166)	79.5 (33–145)	83.0 (49–166)
Employment status, n (%)				.0033
Full time (>30 h/week)	40 (26.7)	23 (31.9)	17 (21.8)
Part time	15 (10.0)	12 (16.7)	3 (3.8)
Retired	79 (52.7)	29 (40.3)	50 (64.1)
Homemaker	5 (3.3)	2 (2.8)	3 (3.8)
Student	0 (0.0)	0 (0.0)	0 (0.0)
Unemployed	2 (1.3)	2 (2.8)	0 (0.0)
Disabled	6 (4.0)	1 (1.4)	5 (6.4)
Other	3 (2.0)	3 (4.2)	0 (0.0)
Prefers not to answer	0 (0.0)	0 (0.0)	0 (0.0)
Health insurance, n (%)
Not Insured	0 (0.0)	0 (0.0)	0 (0.0)	NA
Private Commercial	97 (64.7)	50 (69.4)	47 (60.3)	.3051
Through patient’s employer	59 (60.8)	36 (72.0)	23 (48.9)
Through state healthcare exchange	1 (1.0)	0 (0.0)	1 (2.1)
Patient-obtained insurance	37 (38.1)	14 (28.0)	23 (48.9)
Medicare	78 (52.0)	32 (44.4)	46 (59.0)	.1017
Medicare Advantage	12 (8.0)	5 (6.9)	7 (9.0)	.7673
Medicaid	10 (6.7)	4 (5.6)	6 (7.7)	.7474
VA/TRICARE	2 (1.3)	0 (0.0)	2 (2.6)	.4974

Abbreviations. GLM, golimumab; IFX, infliximab; IV, intravenous; NA, not assessed; SD, standard deviation; VA, Veteran’s Affairs.

Table 3. Patient medical and treatment history.

	By treatment group
Characteristic	Overall (n = 150)	GLM-IV (n = 72)	IFX (n = 78)	p-value
Time since RA diagnosis, months				.4172
Mean (SD)	126.3 (110.05)	118.6 (100.63)	133.3 (118.29)
Median (range)	94.9 (8–676)	82.2 (8–452)	101.3 (10–676)
Time since first exposure to current infusion treatment, months				<.0001
Mean (SD)	31.0 (47.07)	11.2 (9.67)	49.2 (59.15)
Median (range)	14.0 (0–202)	11.4 (0–34)	20.9 (0–202)
Current methotrexate use, n (%)				.7441
Yes	83 (55.3)	41 (56.9)	42 (53.8)
No	67 (44.7)	31 (43.1)	36 (46.2)
# previous RA biologic used, n (%)				<.0001
0	14 (9.3)	12 (16.7)	2 (2.6)
1	12 (8.0)	6 (8.3)	6 (7.7)
2	4 (2.7)	3 (4.2)	1 (1.3)
3–10	53 (35.3)	32 (44.4)	21 (26.9)
>10	67 (44.7)	19 (26.4)	48 (61.5)
Pre-medications administered prior to infusion visit, n (%)	30 (20.0)	4 (5.6)	26 (33.3)	<.0001
Pre-medications administered onsite, n (%)
Oral	50 (33.3)	15 (20.8)	35 (44.9)	.0019
IV	28 (18.7)	1 (1.4)	27 (34.6)	<.0001

Abbreviations. GLM, golimumab; IFX, infliximab; IV, intravenous; RA, rheumatoid arthritis; SD, standard deviation.

Figure 1. (a) RA medication infusion by time. RA medication infusion time was calculated as the time the nurse confirms initiation of the RA medication drip to when the nurse verifies conclusion of the medication drip. Infusion process time was calculated as the sum of the total time for RA infusion medication preparation, time for patient preparation and time required for RA medication infusion. (b) Changes to RA infusion during routine monitoring.

Abbreviations: GLM, golimumab; IFX, infliximab; IV, intravenous; RA, rheumatoid arthritis.

Figure 2. Patient satisfaction (modified) TSQM-IV RA. A higher score indicates more satisfaction, ease, concern, or confidence (scale 1–7). (Q1) How satisfied or dissatisfied are you with the ability of the infusion medication to treat your RA? (Q2) How satisfied or dissatisfied are you with the way the infusion medication relieves your RA symptoms? (Q3) How satisfied or dissatisfied are you with the amount of time it takes the infusion medication to start working to relieve your RA? (Q4) How easy or difficult is it to schedule an appointment for your infusion? (Q5) How satisfied are you with the time it takes to receive your infusion? (p < .0001) (Q6) How satisfied are you with the time it takes from when you enter the infusion center until you can leave? (p = .0003) (Q8) How concerned are you about having a side-effect from the oral or intravenous preventative medication given just prior to the infusion? (Q9) Overall, based on your actual experience, how confident are you that taking this preventative medication just prior to infusion is a good thing for you? (Q10) With all things considered, how satisfied or dissatisfied are you with the total infusion experience and the treatment of your rheumatoid arthritis? Permission to use the TSQM-IV RA was provided by Quintiles.

*Question was asked only if patient received oral or IV medication prior to infusion. Responses: GLM-IV, n = 12; IFX, n = 54.Note: 3 patients did not complete the questionnaire; 2 for golimumab injection (IV) and 1 for infliximab.Abbreviations: GLM, golimumab; IFX, infliximab; IV, intravenous; RA, rheumatoid arthritis; TSQM-IV RA, Treatment Satisfaction Questionnaire for Medication-Intravenous RA, version 1.

Figure 3. Clinic personnel satisfaction. Assessed by a Likert scale (0–10); a higher score indicates greater satisfaction. Q1: How satisfied are you with the time is takes to mix the RA medication into the infusion medication bag? Q2: How satisfied are you with the ease of mixing the RA medication? Q3: How satisfied are you with the frequency of RA medication patients requiring pre-medication? Q4: How satisfied are you with the amount of time it takes to infuse infliximab/golimumab injection (IV)?

Abbreviations: GLM, golimumab; IFX, infliximab; IV, intravenous; RA, rheumatoid arthritis.