Quantifying Patient Preferences for Risk Tolerance With Novel Dual Biologic Therapies for Inflammatory Bowel Disease

Area of Science:

• Gastroenterology
• Pharmacoeconomics
• Patient-reported outcomes

Background:

• Many inflammatory bowel disease (IBD) patients face treatment failures with existing therapies.
• Dual biologic therapy (DBT) is emerging as a strategy to improve outcomes in refractory IBD.
• Understanding patient preferences for DBT is crucial for optimizing treatment strategies.

Purpose of the Study:

• To assess patient preferences regarding dual biologic therapy (DBT) versus monotherapy in IBD.
• To evaluate patient tolerance for risks associated with advanced IBD therapies.
• To determine patient willingness to accept increased risks for improved efficacy.

Main Methods:

• A discrete-choice experiment (DCE) was designed based on existing preference studies.
• Recruited individuals with Crohn's disease or ulcerative colitis who failed advanced therapies.
• Analyzed DCE responses using a random parameters logit model to quantify preferences.

Main Results:

• 280 IBD patients completed the DCE survey.
• No significant preference was found between DBT and monotherapy (P=0.25).
• Patients strongly preferred avoiding corticosteroids (P<0.001) and would accept a 17.5% risk of serious infection for a 20% increase in remission rates.

Conclusions:

• Patients prioritize safe and effective treatments for IBD.
• DBT is a potentially acceptable option for IBD patients who have not responded to advanced therapies.
• Efficient DCE studies are valuable for identifying patient preferences and improving IBD care.