Patient preferences toward the attributes of treatment used for inflammatory bowel disease in Saudi Arabia: Subgroup analysis from an international multicenter discrete choice experiment

Abstract

Background:
Inflammatory bowel diseases (IBD), including Crohn’s disease (CD), and ulcerative colitis (UC), are chronic autoimmune disorders with increasing prevalence in Saudi Arabia (KSA). Understanding patient treatment preferences is important for improving adherence and quality of life. This study evaluated treatment preferences in KSA within the context of the overall five-country cohort (Argentina, Australia, Brazil, Taiwan, and KSA), without conducting formal cross-country comparisons.


Methods:
A cross-sectional survey (October 2022–May 2023) used discrete choice experiments (DCE) to assess preferences for treatment attributes, including safety, efficacy, and route of administration (RoA). Adults (≥18 years) with self-reported CD or UC receiving treatment for ≥6 months were included.


Results:
Data from 353 patients with CD and 353 with UC were analyzed, including 102 from KSA (51 CD, 51 UC). Preferences in KSA were largely consistent with the overall cohort. CD patients prioritized long-term remission, while UC patients valued corticosteroid-free remission at 1 year. Descriptively, KSA patients appeared to place relatively greater emphasis on safety attributes compared with the overall cohort—particularly serious adverse events (AEs) in both CD and UC, and mild AEs in UC—and less emphasis on mucosal healing and RoA. Abdominal pain (CD) and rectal bleeding (UC) most affected quality of life and daily activities. KSA patients also reported lower exposure to advanced therapies (0% in CD and 11.8% in UC). However, given the limited sample size and absence of formal statistical testing, these observations between countries should be interpreted as exploratory.


Conclusions:
Personalized IBD management in KSA is needed. Incorporating patient preferences into clinical decision-making may improve adherence and outcomes.