Kelley Myers

Aims: To evaluate the relative importance of attributes driving obesity medication (OM) choice and preferences among individuals with overweight or obesity. Materials and Methods: US adults with obesity or overweight and ≥ 1 obesity‐related complication completed an online survey including a discrete‐choice experiment (DCE) in October–November 2025. In the DCE, participants chose between 2 hypothetical, experimentally designed OM profiles with attributes/levels related to efficacy, cardiovascular (CV) risk reduction, side effects, administration (route/frequency), and dosing instruction requirements. In a fixed‐choice comparison, participants chose between 2 predefined oral OM profiles. Relative preference weights for the DCE attribute levels were estimated using a random‐parameters logit model to estimate attribute importance, tradeoffs, and predicted treatment choice. Results: Among 800 participants (400 OM‐naïve/400 OM‐experienced, 400 injection‐naïve/400 injection‐experienced), the most important attributes were route of administration, average weight‐loss percentage, CV risk reduction, and the proportion of people achieving ≥ 20% weight loss. Dosing instructions had the lowest relative importance. There was a preference for 1 OM profile (Treatment A—a hypothetical oral semaglutide‐like profile) over the alternative OM profile (Treatment B—a hypothetical orforglipron‐like profile), according to the responses from the DCE (84.2% vs. 15.8%) and the fixed‐choice question (90.0% vs. 10.0%). Only 23.4% indicated that taking an OM treatment on an empty stomach and waiting 30 min to eat would be disruptive to their lives. Most (73.3%) OM‐naïve participants were open to taking an oral OM. Conclusions: Individuals with overweight or obesity prioritise weight‐loss efficacy, CV risk reduction, and oral administration in OM treatment decisions; dosing instruction requirements were of low importance.

Introduction Benefit–risk profiles and mode/frequency of administration vary among the four US-approved treatments for anti-aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-Ab+ NMOSD), but no published studies have reported treatment preferences among patients with NMOSD in the USA. Therefore, the objective of this study was to quantify preferences and predict treatment choices among patients with AQP4-Ab+ NMOSD in the USA. Methods A cross-sectional, web-based discrete choice experiment survey was administered to patients with self-reported AQP4-Ab+ NMOSD. Respondents evaluated hypothetical AQP4-Ab+ NMOSD treatment profile pairs defined by efficacy, safety, process-related attributes, and administration mode/frequency. Data were analyzed using a random-parameters logit model to estimate conditional relative importance of attributes, minimum acceptable benefit, and predicted treatment choice in pairwise treatment profile (ravulizumab-like, eculizumab-like, inebilizumab-like, and satralizumab-like) comparisons. Preference heterogeneity was investigated by exploratory subgroup analysis using interaction terms in the regression analysis. Results The 255 survey completers (mean ± standard deviation [SD] age, 41.4 ± 13.7 years) averaged 6.6 ± 5.4 years since diagnosis, and 63.5% identified as female and 46.7% as Black or African American. Rituximab was the most common treatment (34.1% of respondents), and 15.7%, 9.4%, or 7.1% of respondents were receiving eculizumab, inebilizumab, or satralizumab, respectively. Respondents placed greater importance on reducing chance of relapse within the first year of treatment compared with other attributes such as reducing administration frequency from every 2 weeks to every 8 weeks (Q8W); safety attributes (risks of serious opportunistic or recurrent infection, elevated liver enzymes, and meningococcal infection) were rated similar to each other in importance. Pairwise comparisons favored the ravulizumab-like profile (67.8–87.7%) over the other three treatment profiles (12.3–32.2%). Preferences did not vary by age, disease duration, disease impact, or relapses in the past 12 months, but subgroups defined by current treatment type demonstrated different (p = 0.066) preferences. Respondents receiving intravenous/subcutaneous injections alone or with oral immunosuppressive therapy/corticosteroid treatments placed greater importance on reducing chance of relapse versus those receiving oral treatments alone, but they were not more likely to select a Q24W treatment over a Q8W treatment. Conclusions Respondents with AQP4-Ab+ NMOSD placed the highest importance on reducing chance of relapse, placed a high importance on reduced administration frequency, and rated the safety attributes (avoiding treatments with a risk of meningococcal infection, risk of elevated liver enzymes, and risk of other infections) as comparable to each other but less influential than relapse prevention. Respondents were more likely to select a ravulizumab-like profile over comparators. These findings can inform shared decision-making in selecting treatments.

Objectives: This study was conducted among participants with episodic migraine, to (i) assess patient preferences for attributes associated with calcitonin gene‐related peptide‐targeting therapies to prevent migraine and (ii) predict the probability that a real‐world patient would prefer an atogepant‐like treatment profile over monoclonal antibody‐like profiles.Background: Calcitonin gene‐related peptide‐targeting therapies have emerged as safe and effective first‐line preventive treatments for migraine. Given the expansion of the treatment landscape, it is important to understand what drives treatment choices among patients with migraine. However, few studies have quantified patient preferences for attributes of preventive treatments for migraine.Methods: A discrete‐choice experiment survey was administered to adults (aged 18–80 years and <50 years at age of migraine onset) with episodic migraine who were naïve to calcitonin gene‐related peptide‐targeting therapies between November and December 2020. Respondents were presented with pairs of hypothetical treatment profiles defined by seven attributes with varying levels. Preference weights were used to estimate the conditional relative importance of each attribute and the probability that an average respondent in the sample would prefer an atogepant‐like treatment relative to monoclonal antibody‐like treatment profiles. No a priori hypotheses were evaluated related to treatment preference.Results: Across the attributes and levels included in the study, the relative importance estimates revealed that, on average, the two most important changes in treatment attributes were (i) having a treatment with no nausea instead of a treatment with moderate‐to‐severe nausea and (ii) having a treatment administered by oral pill or tablet instead of a self‐injection once every month or intravenous infusion once every 3 months. For example, respondents valued having a treatment administered by daily oral pill instead of by quarterly intravenous infusion ~2.5 times more than avoiding a treatment with mild nausea. The predicted probability that an average respondent in the sample would prefer an oral, once‐daily atogepant‐like profile was higher than the predicted probability that an average respondent in the sample would prefer a specific monoclonal antibody‐like injectable profile (range, 70.9%–85.4%) or a composite profile representing monoclonal antibodies as a class of drugs (range, 70.7%–73.8%), even when efficacy of the monoclonal antibody‐like profile was similar to the atogepant‐like profile.Conclusion: Relative importance estimates suggest that, on average, respondents with episodic migraine preferred an oral pill over monthly or quarterly injections and infusions. Respondents also preferred to avoid treatment‐related nausea and constipation. The predicted choice probability results further suggest a preference for a daily oral pill, given that seven of 10 respondents, on average, would prefer a profile similar to atogepant over profiles similar to monoclonal antibodies administered intravenously or by self‐injection.

Aim: Patient preferences for the features of targeted chronic lymphocytic leukemia (CLL) therapies may differ.Materials & methods: A discrete-choice experiment (DCE) survey was administered to 229 respondents recruited through the CLL Society.Results: Respondents placed most importance on increasing the chance of progression-free survival (PFS) at 2 years from 70 to 90% and confirming results with measurable residual disease (MRD) testing instead of routine testing. Respondents also preferred daily oral administration over intravenous infusion every 4 weeks, fixed-duration treatments over treat-to-progression treatments and treatments with lower side effect risks. Reducing risk of tumor lysis syndrome was least important relative to changes in other attributes.Conclusion: The combination of improving PFS combined with confirming results using MRD testing was more important than changes in all other study attributes included in the DCE. Results from this study can help inform shared decision-making when selecting therapies for CLL.

Introduction Despite recent advances in treatment for psoriatic arthritis (PsA), many patients experience inadequate response or intolerance to therapy, indicating that unmet treatment-related needs remain. To further characterize these unmet needs, we evaluated patients’ experiences regarding the burden of PsA symptoms and disease impacts, and patients’ preferences for treatment. Methods Patients from ArthritisPower, a rheumatology research registry, completed a web-based survey. Object case best–worst scaling (BWS) was used to evaluate the relative burden of 11 PsA-related symptoms and the relative importance of improvement in nine PsA-related disease impacts. BWS data were analyzed using a random-parameters logit model. Patient demographics, preferences for mode and frequency of therapy, and preferences for methotrexate were analyzed descriptively. Results Among the 332 participants, most were White (94%), female (80%), with mean age of 54 years (SD 11.4). In the BWS, joint pain was the most bothersome symptom, followed by other musculoskeletal pain and fatigue. The BWS for disease impacts found that improvements in the ability to perform physical activities were most important, followed by improvements in the ability to function independently, sleep quality, and the ability to perform daily activities. The most burdensome symptoms and desired disease impact improvements were similar in patients regardless of their experience with biologic disease-modifying antirheumatic drugs. The most preferred mode and frequency of treatment administration was oral, once-daily medication (preferred by 38% of respondents), and 74% prioritized therapies that significantly improved joint-related symptoms versus psoriasis-related symptoms. The majority of respondents (65%) preferred PsA treatment regimens that did not include methotrexate. Conclusions Patients with PsA from a rheumatology registry found musculoskeletal pain symptoms to be the most bothersome and prioritized improvements to functional impacts of their disease. These findings can better inform development of new therapies and guide shared patient-provider treatment decision-making.

What is the context? What is the impact? Graphical abstract

Background: Adverse events (e.g., pyrexia) may affect treatment patterns and adherence. This study explored pyrexia risk tolerance among melanoma patients when treatment benefit is unknown versus k...

Introduction In 2014, the Advisory Committee on Immunization Practices (ACIP) of the US Centers for Disease Control and Prevention (CDC) recommended 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) for all adults aged ≥ 65 years, with a commitment to revisit the recommendation for PCV13 because of declining vaccine-type disease. The Evidence-to-Recommendation framework used by the ACIP includes review of evidence regarding feasibility and stakeholder acceptability, but no surveys of vaccinator preferences have been published in the literature. Methods Physicians (N = 700), physician assistants (N = 100), pharmacists (N = 100), and nurse practitioners (N = 100) who recently prescribed, administered, or recommended adult pneumococcal vaccine were surveyed in March 2018. Object-case best–worst scaling was used to assess preferences among potential recommendation scenarios: retaining the then-current 2014 recommendation without a scheduled re-evaluation, retaining with a scheduled re-evaluation, revising PCV13 to Category B (retaining PPSV23 as Category A), removing PCV13 (retaining PPSV23 as Category A), and removing both PCV13 and PPSV23. Results Providers’ most preferred recommendations were retaining the 2014 recommendation with another planned re-evaluation (52.6%) and retaining the then-current recommendation without planned re-evaluation (40.0%). Few preferred changing PCV13 to Category B (3.2%), removing PCV13 (3.7%), or removing both pneumococcal vaccines (0.5%). Conclusions The majority of vaccinators surveyed preferred to retain the 2014 recommendation, either with another scheduled reassessment or indefinitely. Funding Pfizer, Inc.