Patients' Preference for a Specific Anti-Tumor Necrosis Factor Agent: Korea versus Western.

The introduction of anti-tumor necrosis factor (TNF) agents for treatment of inflammatory bowel disease (IBD) has changed the treatment paradigm for both Crohn’s disease (CD) and ulcerative colitis. Currently, two anti-TNF agents, infliximab (IFX) and adalimumab (ADA), are available in clinical practice in Korea. In general, these anti-TNF agents have demonstrated similar efficacies in the induction and maintenance of clinical remission and responses in moderate to severe CD. However, there are no head-to-head comparative trials available to indicate the best options among commercially available anti-TNF agents. Therefore, factors other than efficacy and safety, such as availability, route of administration, patient preference, cost and national guidance, should also be considered when choosing a specific anti-TNF agent. In fact, selecting a specific antiTNF drug is a typical preference-sensitive decision an individual patient will make in the management of their IBD. Moreover, patients’ preferences for specific anti-TNF agents may vary depending on cultural factors. However, data on the preferences of CD patients, especially those in Asia, for anti-TNF agents are very limited. In this issue of Gut and Liver, Kim et al. reported the results of the CHOICE study, which investigated the preferences of Korean patients with CD for IFX and ADA and the contributing factors for their preferences. They conducted a prospective questionnaire survey of 189 patients from 10 tertiary referral centers in South Korea. The authors showed that anti-TNF-naïve CD patients were more likely to favor IFX over ADA. Several studies have investigated patients’ preference for routes of administration of anti-TNF agents in Western settings (Table 1). Interestingly, the findings of Kim et al. are