Patient preferences and experiences regarding thrombopoietin-receptor agonists for immune thrombocytopenia in The Netherlands (TRAPeze Netherlands study).

OBJECTIVE: Identify patient experience and preference towards thrombopoietin-receptor agonists (TPO-RAs) in treatment of immune thrombocytopenia (ITP) in the Netherlands. METHODS: The Thrombopoietin-Receptor Agonist Patient experience (TRAPeze) survey used a discrete choice experiment (DCE) to elicit patient preferences and a patient burden survey (PBS) to evaluate the clinical and social impact of ITP. TRAPeze collected responses from 6th October to 19th November 2021. RESULTS: Seventy-six respondents completed the DCE: treatment preference appeared to be driven by method of administration (odds ratio [OR] 4.33; 95% confidence interval [CI] 2.88-6.52), frequency of dosing (OR 2.33; 95% CI 1.86-2.92) and drug-food interactions (OR 1.91; 95% CI 1.54-2.37). Respondents preferred therapies delivered orally over subcutaneous injection (OR 4.22; 95% CI 2.76-6.46), dosed once weekly over once daily (OR 2.37; 95% CI 1.58-3.54) and without food restrictions over with restrictions (OR 1.90; 95% CI 1.52-2.38). Sixty-nine respondents completed the DCE and PBS (mean [range] age 53 [19-83] years, 65% female). Seven incomplete PBS responses were excluded from analysis. Respondents were currently, or most recently, receiving eltrombopag (n = 43) or romiplostim (n = 26), of which 30% (n = 21/69) had previously received another TPO-RA. Loss (29%, n = 6/21) and lack (29%, n = 6/21) of response were the most common reasons for switching TPO-RA. Only 28% (n = 18/65) of respondents felt their TPO-RA increased energy levels. CONCLUSION: Patients preferred therapies delivered orally, dosed less frequently and without food restrictions. QoL of ITP patients on TPO-RAs can be improved; the burden analyses presented can inform future efforts towards this.

Macular pigment and melanin in age-related maculopathy in a general population.

PURPOSE: It has been suggested that macular pigment (MP) and melanin may protect against age-related maculopathy (ARM). To check this, MP and melanin optical density were measured in a random population-based sample of subjects 55 years of age or older. METHODS: Spectral fundus reflectance of the fovea was measured in one eye per subject in a 2.3 degrees detection field with a fundus reflectometer. The sample consisted of 199 men and 236 women. Analysis with a fundus reflectance model yielded individual estimates for the MP and melanin optical density. Diagnosis of ARM was based on grading of standardized fundus transparencies. Eyes were stratified in four exclusive stages of ARM. RESULTS: MP optical density (at 460 nm) was 0.33 +/- 0.15 in eyes without ARM (n = 289) and 0.33 +/- 0.16 in eyes at any stage of ARM (n = 146). Melanin optical density (at 500 nm) was 1.18 +/- 0.19 in eyes without ARM and 1.20 +/- 0.21 in eyes at any stage of ARM. We found no gender differences for either MP or melanin optical density. CONCLUSIONS: No differences in MP and melanin optical density were found between eyes with and without ARM or between the various ARM stages.