Gut Liver.  2016 May;10(3):391-398. 10.5009/gnl15126.

Factors Contributing to the Preference of Korean Patients with Crohn's Disease When Selecting an Anti-Tumor Necrosis Factor Agent (CHOICE Study)

  • 1Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
  • 2Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
  • 3Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
  • 4Department of Internal Medicine, The Catholic University of Korea College of Medicine, Suwon, Korea.
  • 5Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea.
  • 6Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea.
  • 7Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
  • 8Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
  • 9Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea.
  • 10Department of Internal Medicine, Inje University College of Medicine, Busan, Korea.
  • 11Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
  • 12Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.
  • 13Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea.


Two comparable anti-tumor necrosis factor (TNF) agents with different routes of administration (intravenous [iv] infliximab [IFX] vs subcutaneous [sc] adalimumab [ADA]) are available for patients with Crohn's disease (CD) in Korea. This study aimed to identify the preferences of Korean CD patients for a specific anti-TNF agent and the factors contributing to the decision.
A prospective survey was performed among anti-TNF-naive CD patients in 10 tertiary referral hospitals. A 16-item questionnaire addressed patient preferences and the factors contributing to the decision in favor of a particular anti-TNF agent. A logistic regression was conducted to assess predictive factors for ADA preference.
Overall, 189 patients (139 males; mean age, 32.47±11.71 years) completed the questionnaire. IFX and ADA were preferred by 63.5% (120/189) and 36.5% (69/189) of patients, respectively. The most influential reason for choosing IFX was "˜doctor's presence' (68.3%, 82/120), and ADA was "easy to use" (34.8%, 24/69). Amid various clinicodemographic data, having a >60-minute travel time to the hospital was a significant independent predictive factor for ADA preference.
A large number of anti-TNF-naive Korean patients with CD preferred anti-TNFs with an iv route of administration. The reassuring effect of a doctor's presence might be the main contributing factor for this decision.


Crohn disease; Infliximab; Adalimumab; Preference

MeSH Terms

Adalimumab/therapeutic use
Antibodies, Monoclonal, Humanized/therapeutic use
Biological Products/*therapeutic use
Crohn Disease/*drug therapy/psychology
Cross-Sectional Studies
Gastrointestinal Agents/*therapeutic use
Infliximab/therapeutic use
Infusions, Intravenous
Injections, Subcutaneous
Patient Preference/*psychology
Prospective Studies
Republic of Korea
Surveys and Questionnaires
Tumor Necrosis Factor-alpha/*antagonists & inhibitors
Antibodies, Monoclonal, Humanized
Biological Products
Gastrointestinal Agents
Tumor Necrosis Factor-alpha
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