Patient Preferences Regarding Thrombopoietin-Receptor Agonists for Immune Thrombocytopenia in Italy (TRAPeze Italy Study)

OBJECTIVES: The Thrombopoietin-Receptor Agonist Patient experience (TRAPeze) survey aims to identify patient preference towards specific thrombopoietin-receptor agonists (TPO-RAs) and determine immune thrombocytopenia (ITP) clinical and social impact. Here the Italian sub-study is reported.

METHODS: TRAPeze used a discrete choice experiment (DCE) to elicit patient preferences towards TPO-RA attributes. A patient burden survey (PBS) determined ITP disease characteristics and social impact. Respondents were recruited by the Italian ITP patient association, Associazione Italiana Porpora Immune Trombocitopenica (AIPIT).

RESULTS: 76 respondents completed the DCE, of which 69 completed both the DCE and PBS (mean [range] age 45.4 [18.0–73.0] years, 79.7% female). Mean self-reported health state score was 7.1 out of 10 (10 being excellent health), median (range) platelet count was 75.0x10⁹/L (4.0-400x10⁹). Most commonly reported ITP symptoms were bruising (78.3%), petechiae (62.3%) and fatigue (60.9%). 48.5% of respondents reported their condition worsening since diagnosis, 84% felt ITP impacted familial relationships and 70.9% of employed respondents reported fatigue influenced their ability to fulfil occupational responsibilities.

TPO-RA attributes most likely to influence patient preference were method of administration (odds ratio [OR] 2.96; 95% confidence interval [CI] 2.16–4.06), drug-food interactions (OR 1.48; 95% CI 1.17–1.86) and frequency of dosing (OR 1.32; 95% CI 1.15–1.52). Respondents were more likely to prefer orally administered therapies over subcutaneous injection (OR 3.76; 95% CI 2.51–5.63), therapies administered once weekly over once daily (OR 1.83; 95% CI 1.26–2.65), and therapies without food restrictions over with restrictions (OR 1.58; 95% CI 1.17–2.14).

CONCLUSIONS: Despite scores indicating a moderate perception of general health, responses also indicate a persistent impact of ITP on relationships and employment. The findings demonstrate respondents prefer oral tablets, therapies with less frequent dosing and without food restrictions. Evidence from the patient perspective on treatment preference and disease characteristics may facilitate ITP management.