Retention rate of a novel autoinjector e-Device introduced to patients with chronic arthritis treated with certolizumab pegol in clinical practice: an observational implementation study

Abstract

Objectives

The objectives were to explore the clinical retention rate of an e-Device aimed at empowering chronic arthritis patients using certolizumab pegol (CZP) and to analyse beliefs about medication in the Danish population.

Method

Patients treated with CZP were recruited from the Netherlands, Denmark, and Sweden through rheumatology clinics at initiation of, or switching to, the e-Device. Patients were adults (aged 18–85 years) diagnosed with rheumatoid arthritis, axial spondyloarthritis, or psoriatic arthritis. Patients administered three consecutive self-injections at home. Descriptive statistics regarding baseline characteristics, retention rates, and reasons for withdrawal were assessed, along with the Beliefs about Medicines Questionnaire.

Results

In total, 59 patients participated (Netherlands 25, Denmark 15, Sweden 19). Most subjects (71%) were women, with a mean ± sd age of 55 ± 16.2 years and mean disease duration 12 ± 8.8 years. Six patients (10%) started CZP de novo and the remaining patients switched device. The overall retention rate was 42% after 52 weeks, declining to 38% after 104 weeks. A sharp decline, 34%, was seen at week 8. Between weeks 32 and 112, only four patients (6.8%) withdrew from the study. The primary reason for withdrawal was the patient’s request. Stratification by country showed significant differences for some outcomes.

Conclusion

An initial large dropout was evident within the first 8 weeks, with almost no dropouts thereafter. The reasons for withdrawal were primarily patient requests. Thus, the injection experience must be tailored carefully when selecting patients for new autoinjector e-Devices to enhance retention rates and patient satisfaction.

Acknowledgements

The authors thank the patients, the investigators, and their teams, who took part in this study.

A special thanks to research nurse Marianne Petersson, Linköping.

Disclosure statement

TSJ discloses speaker’s bureaux: AbbVie, Roche, Novartis, UCB, Biogen, Eli Lilly, and Pfizer; CS discloses speaker’s bureaux: Bristol-Myers Squibb, Fresenius Kabi, Novartis, and AstraZeneca; LEK discloses speaker’s bureaux: Pfizer, AbbVie, Amgen, UCB, Sanofi, Biogen, Gilead, Bristol-Myers Squibb, MSD, Novartis, Eli Lilly, and Janssen Pharmaceuticals. RLH, BP, and BVB have no potential conflicts of interest to declare.

Author contributions

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval regarding the version to be published.

Ethical considerations

All procedures were performed in accordance with the ethical standards of the responsible committee and with the Helsinki Declaration of 1964, as revised in 2013. Informed consent was obtained from all patients before being included in the study, and ethical approval was obtained from the Regional Ethical Committee (decision number 17019973).

Additional information

Funding

This study was funded by UCB Pharma.