Patients Prefer Sub-Q to IV, Review Finds

Patients have prefer subcutaneous administration of biologics, often done at home with prefilled syringes, to intravenous administration at hospital, according to a recent of review studies of published in the Journal of Comparative Effectiveness Research.

A majority of the patients in 13 of the 14 studies of patients with autoimmune disease identified by the researchers preferred subcutaneous administration. When the researchers combined the study in to a meta-analysis, they found 83% of patients with an autoimmune disease preferred subcutaneous administration and 80% of those with a primary immunodeficiency, which are commonly treated with subcutaneous immunoglobulins.

Studies that measured treatment satisfaction also favored subcutaneous administration but the results were not as clear cut, reported corresponding author Ann Gardulf of the Karolinska Institutet in Stockholm, Sweden. In the larger study of patients with lupus, 100% were satisfied with subcutaneous administration compared with 79% of those treated intravenously. But Gardulf and her colleagues described the results of a smaller study as mixed.

These results fall into line with current thinking and common sense about subcutaneous administration, which can be done at home and therefore has the benefits of convenience. Gardulf and her colleagues note that reviews of studies of patients with specific conditions — primary immunodeficiency and rheumatoid arthritis — have arrived at similar conclusions. But there are some interesting nuances to consider. Gardulf and her colleagues note that treatment effectiveness and general health are part of the measurement, there is little difference between subcutaneous and intravenous administration.

“Patient preferences and circumstances can be very individual, and self-administration may not be suitable for all patients,” they wrote in the conclusion of the study, which was published in August 2024. They say that subcutaneous administration is most likely to be most suitable for patients who are confident about the effectiveness of the treatment and wish to have greater autonomy.