PMID- 35238334 OWN - NLM STAT- MEDLINE DCOM- 20221010 LR - 20221017 IS - 1462-0332 (Electronic) IS - 1462-0324 (Print) IS - 1462-0324 (Linking) VI - 61 IP - 10 DP - 2022 Oct 6 TI - Patient preferences for the treatment of systemic sclerosis-associated interstitial lung disease: a discrete choice experiment. PG - 4035-4046 LID - 10.1093/rheumatology/keac126 [doi] AB - OBJECTIVES: Treatments for SSc-associated interstitial lung disease (SSc-ILD) differ in attributes, i.e. mode of administration, adverse events (AEs) and efficacy. As physicians and patients may perceive treatments differently, shared decision-making can be essential for optimal treatment provision. We therefore aimed to quantify patient preferences for different treatment attributes. METHODS: Seven SSc-ILD attributes were identified from mixed-methods research and clinician input: mode of administration, shortness of breath, skin tightness, cough, tiredness, risk of gastrointestinal AEs (GI-AEs) and risk of serious and non-serious infections. Patients with SSc-ILD completed an online discrete choice experiment (DCE) in which they were asked to repeatedly choose between two alternatives characterized by varying severity levels of the included attributes. The data were analysed using a multinomial logit model; relative attribute importance and maximum acceptable risk measures were calculated. RESULTS: Overall, 231 patients with SSc-ILD completed the DCE. Patients preferred twice-daily oral treatments and 6-12 monthly infusions. Patients' choices were mostly influenced by the risk of GI-AEs or infections. Improvement was more important in respiratory symptoms than in skin tightness. Concerning trade-offs, patients accepted different levels of increase in GI-AE risk: +21% if it reduced the infusions' frequency; +15% if changing to an oral treatment; up to +37% if it improved breathlessness; and up to +36% if it reduced the risk of infections. CONCLUSIONS: This is the first study to quantitatively elicit patients' preferences for treatment attributes in SSc-ILD. Patients showed willingness to make trade-offs, providing a firm basis for shared decision-making in clinical practice. CI - (c) The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. FAU - Bruni, Cosimo AU - Bruni C AUID- ORCID: 0000-0003-2813-2083 AD - Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence, Florence, Italy. FAU - Heidenreich, Sebastian AU - Heidenreich S AD - Patient-Centered Research, Evidera, London, UK. FAU - Duenas, Ashley AU - Duenas A AD - Patient-Centered Research, Evidera, London, UK. FAU - Hoffmann-Vold, Anna-Maria AU - Hoffmann-Vold AM AUID- ORCID: 0000-0001-6467-7422 AD - Department of Rheumatology, Oslo University Hospital, Oslo, Norway. FAU - Gabrielli, Armando AU - Gabrielli A AD - Department of Clinical and Molecular Sciences, Universita Politecnica delle Marche, Ancona, Italy. FAU - Allanore, Yannick AU - Allanore Y AD - Department of Rheumatology A, Cochin Hospital, Paris Descartes University, Paris. FAU - Chatelus, Emmanuel AU - Chatelus E AD - Department of Rheumatology, University Hospital of Strasbourg, Hopital de Hautepierre, Strasbourg, France. FAU - Distler, Jorg H W AU - Distler JHW AD - Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany. FAU - Hachulla, Eric AU - Hachulla E AD - Department of Internal Medicine and Clinical Immunology, Referral Centre for Centre for rare systemic autoimmune diseases North and North-West of France (CeRAINO), CHU Lille, University of Lille, Inserm, U1286 - INFINITE-Institute for Translational Research in Inflammation, Lille, France. FAU - Hsu, Vivien M AU - Hsu VM AD - Department of Medicine, Division of Rheumatology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA. FAU - Hunzelmann, Nicolas AU - Hunzelmann N AD - Department of Dermatology, University of Cologne, Cologne, Germany. FAU - Khanna, Dinesh AU - Khanna D AD - Scleroderma Program. AD - Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. FAU - Truchetet, Marie-Elise AU - Truchetet ME AD - Department of Rheumatology, CHU Bordeaux, Bordeaux, France. FAU - Walker, Ulrich A AU - Walker UA AD - Department of Rheumatology, University Hospital Basel, Basel, Switzerland. FAU - Alves, Margarida AU - Alves M AD - TA Inflammation, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany. FAU - Schoof, Nils AU - Schoof N AD - TA Inflammation, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany. FAU - Saketkoo, Lesley Ann AU - Saketkoo LA AD - New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center. AD - Departments of Internal Medicine, Louisiana State University, and Tulane University Schools of Medicine, New Orleans, LA, USA. FAU - Distler, Oliver AU - Distler O AD - Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - Rheumatology (Oxford) JT - Rheumatology (Oxford, England) JID - 100883501 SB - IM CIN - Nat Rev Rheumatol. 2022 Aug;18(8):433-434. PMID: 35680990 MH - Choice Behavior MH - Humans MH - *Lung Diseases, Interstitial/drug therapy/etiology MH - Patient Preference MH - *Scleroderma, Systemic/complications MH - Surveys and Questionnaires PMC - PMC9536797 OTO - NOTNLM OT - SSc OT - discrete choice experiment OT - interstitial lung disease OT - patient preference EDAT- 2022/03/04 06:00 MHDA- 2022/10/12 06:00 PMCR- 2022/03/03 CRDT- 2022/03/03 08:55 PHST- 2021/10/05 00:00 [received] PHST- 2022/02/17 00:00 [revised] PHST- 2022/03/04 06:00 [pubmed] PHST- 2022/10/12 06:00 [medline] PHST- 2022/03/03 08:55 [entrez] PHST- 2022/03/03 00:00 [pmc-release] AID - 6541624 [pii] AID - keac126 [pii] AID - 10.1093/rheumatology/keac126 [doi] PST - ppublish SO - Rheumatology (Oxford). 2022 Oct 6;61(10):4035-4046. doi: 10.1093/rheumatology/keac126.