How do You Like the Pen? Patients’ Opinion About Switching Adalimumab From Prefilled Syringe to Pen in Inflammatory Bowel Disease

Kata Szántó, Mariann Rutka, Ágnes Milassin, Klaudia Farkas, Anna Fabián, Renáta Bor, Zoltán Szepes, Tibor Nyári, András Lajos Szijártó, István Rácz, Andrea Szabó, Valéria Kovács, Árpád Patai, Krisztina Sarang, Lilla Lakner, László Lakatos, Imre Szabó, Zsolt Szinku, Ágnes Salamon, Károly Palatka, Gábor Horváth, Róbert Sike, Gábor Tamás Tóth, Tamás Molnár


OBJECTIVES: Inflammatory bowel diseases are lifelong illnesses and have a huge impact on the quality of life and workability. Although the fully human anti-tumor necrosis factor-alpha, adalimumab provides great opportunity to use biological therapy at home, application of the prefilled syringe might be difficult for some. The aim of this study was to evaluate patients’ opinion about the newly introduced adalimumab prefilled pen compared to the prefilled syringe.

METHODS: Our questionnaire based survey focused on the degree of difficulty of the usage, any inconveniences and the proportion of self-injection for each mode of administration.

RESULTS: The questionnaire was filled by 101 patients (female/male: 49/52). Patients applied adalimumab therapy for 33 months on average and changed from the prefilled syringes to the prefilled pen for 4 months on average. Sixty-six % of those who used the prefilled syringe administered adalimumab themselves. Self-administration of injections caused difficulties for 19% of patients, and 15% of patients had serious aversion to self-administration. On the other hand, in case of the prefilled pen, 94% of patients administered adalimumab themselves. Self-administration caused difficulties for only 5% of patients, and just 1% of patients reported aversion to self-administration (p < 0.001). Overall 70% of patients assessed the change positively, and they reported significantly less (23.6% vs 9.3%; p = 0.009) inconvenience with administration.

CONCLUSION: Our multicenter study including more than hundred inflammatory bowel diseases patients revealed that switching from the prefilled syringe to pen results in higher self-adminstering rate, significant reduction in pain and in local reaction at the injection site.


Crohn disease; Ulcerative colitis; Adalimumab; Syringe; Pen; Self-administration

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