Patient Preferences for Inflammatory Bowel Disease Treatment: Results from a Global Survey Conducted in Partnership with the European Federation of Crohn's & Ulcerative Colitis Associations.

BACKGROUND

As therapeutic options for inflammatory bowel disease (IBD) expand, understanding patient preferences-and how these vary across subgroups-is critical for patient-centered drug development and evaluation. This patient preference study aimed to (1) determine the relative preference weights of IBD treatment- and disease-related attributes (i.e., which features most influence patients' treatment choices) and (2) explain preference heterogeneity.

METHODS

A survey incorporating a discrete choice experiment (DCE) was disseminated worldwide. Patients repeatedly chose between hypothetical treatment profiles varying across 14 attributes using a partial profile design. The survey design was informed by literature review, qualitative research, and advisory boards. Mixed logit models were applied.

RESULTS

Data from 1452 patients (51.0% Crohn's disease [CD]; 49.0% ulcerative colitis/IBD-unclassified [UC/IBD-U]; mean age 42.5 years; 69.0% female) from 40 countries were analyzed. Psychological impact, abdominal pain and cramps, and bowel urgency were the most influential factors in decision-making. Mode of administration, endoscopic remission, and speed of onset were least influential. Patients with UC/IBD-U attached more importance to surgical risk, toilet-related symptoms, psychological impact, physical changes, and infection risk, whereas CD patients placed greater weight on mode of administration. Significant preference heterogeneity was observed and was partly explained by age, time since diagnosis, gender, geographical region, treatment status, treatment classes received, advanced therapy use, and surgery history.

CONCLUSIONS

IBD patients prioritize psychological well-being and gastrointestinal symptom relief over features distinguishing treatments such as administration method or onset of action. Findings underscore the need to integrate quality-of-life and symptom-based outcomes alongside inflammatory control into trial design, regulatory assessment, and health technology evaluation.