SmartClic/ClicWise Autoinjector Could Ease Burden of Self-Administered Injections in Rheumatoid Arthritis

Rieke Alten, MD, PhD

Data from a study of health care professionals’ opinions of the SmartClic/ClicWise autoinjector device for administering subcutaneously administered biologics in the treatment of rheumatic conditions is providing new insight into the usability and applicability of the device.

Results of the study indicate the feedback provided on questions related to use of the device was positive overall, with more than 90% of health care professionals included in the study estimating 20 minutes or less of training time would suffice for patients to learn how to use the device.

“The results from this study involving 25 HCPs showed positive feedback on the ease of use, feature design, effectiveness, and injection speed of the SmartClic/ClicWise device and planned functionality of its associated optional app,” wrote investigators.

The introduction of biologics in the treatment of rheumatoid arthritis around the turn of the century altered the potential disease course for millions of people with rheumatoid arthritis globally. As with any therapeutic advance in medicine, the availability of an agent is half the battle, with access and adherence often seen as a sizable hurdle for many. Now, decades removed from the introduction of biologics as disease-modifying agents in rheumatoid arthritis, patient adherence remains a barrier to optimal disease management for many. Led by Rieke Alten, MD, PhD, of the Department of Internal Medicine and Rheumatology at the University Medicine Berlin, the study, which was sponsored by Pfizer, was conducted with the intent of evaluating health care professionals’ opinions of the SmartClic/ClicWise autoinjector as it relates to the usability and applicability of the device and its features.

Per study protocol, health care professionals in Germany took part in a training session for the device and gained experience by performing simulated injections with water. At the conclusion of these sessions, participants answered questions related to the ease of use, feature design, effectiveness, injection speed, and time expected for patient training for the device. For the purpose of analysis, Likert scale ratings were used to evaluate patient scores. Of note, the study was conducted from September-October 2020.

Overall, 25 health care professionals participated in the study. This group had a mean age of 38.2 years, 88% were female, and 76% were registered nurses. Among the participants, 20% reported treating rheumatology patients at least weekly, but 96% reported being a member of the care team for a patient with rheumatoid arthritis. All participants reported having experience with administering injections.

Upon analysis, results indicated feedback on questions related to the device was positive overall, with mean Likert scale scores exceeding 4.50 across all questions and scores less than 5.0 reported on just 2 of the 40 questions included. The highest mean Likert scale scores were observed for ease of learning how to use (6.88), confidence the device can be handled safely (6.80), and the injection being easy to start (6.72). The lowest mean Likert scale scores were seen for usability in those with significant hand pain (4.64) and that the injection procedure was not time-consuming (4.52). Investigators called attention to noteworthy inconsistencies observed between mean Likert scale scores and comments made by participating health care professionals. Among these was discordance related to the size of the device, with a group of 10 commenting the device was large or heavy for patient use but mean scores attained for size (5.28), weight (5.68), comfortable to hold/does not slip (5.60), and easy to grip (5.56) not reflecting this belief.

“HCPs reported a high level of usability, functionality, and acceptance of the SmartClic/ClicWise device and the companion app. Further studies are warranted to assess patients’ opinions, and one large patient study is currently underway,” wrote investigators. “However, initial HCP perceptions suggest that the novel SmartClic/ClicWise autoinjector will provide patients with an acceptable alternative for self-administration of therapeutics for the management of RA and other conditions.”

This study, “High Usability and Applicability Ratings for the New SmartClic/ClicWise Injection Device: Evidence from a Health Care Professional Opinion Study,” was published in Rheumatology and Therapy.