Comparison of subcutaneous injection pain and efficacy - assessment of improved adalimumab -

Abstract

Purposes : Subcutaneous injection of adalimumab (ADAsc(0.8)) was known to be painful, but an improved device (ADAsc(0.4)) was approved in November 2016. Here we compared the efficacy and pain level of injection among ADAsc(0.4), ADAsc(0.8), and other subcutaneous injection of biological disease-modifying anti-rheumatic drugs (sc-bDMARDs).
Methods : Patients with rheumatoid arthritis (RA), who were treated by sc-bDMARDs in our hospital, and agreed to take part in this survey, were enrolled （ADAsc group, n=72; other sc-bDMARDs group, n=351).
Results : The disease activity of RA did not change after switching from ADAsc(0.8) to ADAsc(0.4). Injection pain evaluated using the Short-Form McGill Pain Questionnaire version 2 (SF-MPQ-2) improved from 4.50 (1.00-19.0) to 1.00 (0.00-5.00), p<0.001. Furthermore, 55.4% and 78.6% of the patients expressed a marked preference for the ADAsc(0.4) in terms of needle-related pain, and the pain associated with infusion, respectively. Multivariate analysis indicated that more severe injection pain (SF-MPQ-2 score >2) was associated with use of the ADAsc(0.8), abatacept, etanercept, and certrilumab pegol, in comparison to the ADAsc(0.4).
Conclusion : The ADAsc(0.4) has achieved a lower level of injection-related pain, and become more usable.