Randomized crossover study in patients with neuroendocrine tumors to assess patient preference for lanreotide Autogel® given by either self/partner or a health care professional

Viktor Johanson,1 Benedicte Wilson,2 Anna Abrahamsson,3 Constantin Jianu,4 Jan Calissendorff,5 Najme Wall,6 Henning Grønbæk,7 Jon Florholmen,8 Anders Öhberg,9 Dan Granberg101Department of Surgery, Sahlgrenska University Hospital, Göteborg, Sweden; 2Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark; 3Karolinska Institutet, Department of Hepatology, Karolinska University Hospital, Huddinge, Sweden; 4Department of Gastroenterology and Liver Disease, St Olav Hospital, Trondheim, Norway; 5Karolinska Institutet, Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Solna, Sweden; 6Department of Oncology, Linköping University Hospital, Linköping, Sweden; 7Department of Medicine V, Aarhus University Hospital, Aarhus, Denmark; 8Department of Gastroenterology and Nutrition, University Hospital of North Norway, Tromsø, Norway; 9Medical Department, Ipsen AB, Stockholm, Sweden; 10Department of Medical Sciences, Section of Endocrine Oncology, Uppsala University, Uppsala, SwedenBackground: Lanreotide Autogel® is supplied in prefilled syringes. Therefore, it is possible for patients with neuroendocrine tumors to use self-/partner-administered injections. The primary objective of this study was to assess the proportion of patients preferring self/partner injections over injections administered by health care professionals, and to describe the impact of self/partner administration on efficacy, safety, and costs.Methods: Of 62 eligible patients, 26 (42%) patients with neuroendocrine tumors treated with a stable dose of lanreotide Autogel 90 mg or 120 mg every 4 weeks agreed to participate in this Phase IV, international, open-label, crossover study, conducted at hospitals in Sweden, Norway, and Denmark. Patients were randomized to two blocks, starting with administration of lanreotide Autogel by either self/partner or a health care professional. Preference for injections administered by self/partner or health care professionals was measured, as well as efficacy, safety, and health care resource utilization (both direct and indirect costs).Results: Of 25 evaluable patients, 22 (88%) preferred self/partner injections, mainly because they experienced increased independence. Based on all patients asked to participate (n = 62), 35% preferred self/partner injections on a regular basis. There was no difference in efficacy or safety between the two administration blocks.Conclusion: Many patients with neuroendocrine tumors prefer self/partner injection of lanreotide Autogel, and are able to self/partner inject without any impact on efficacy or safety. This administration method seems to provide a good alternative for suitable patients to increase patient independence and reduce the number of clinic visits.Keywords: neuroendocrine tumors, carcinoid syndrome, self administration, somatostatin analogs, lanreotid