A button is just something you press to get a task done. Or is it? Buttons do just about everything, which is why they come in an almost endless variety of shapes and sizes, each tailor-made for the task at hand. We wanted to take a closer look at what makes a button work best so we could design one that acknowledges the very specific needs of patients with rheumatoid arthritis or psoriatic arthritis.
Building a better button
Think about the buttons you interact with every day.
From coffee machines to the buttons on a remote control—even the keys on your computer—buttons are tailored to their task in terms of shape, placement, and ease of use.
Some buttons are intentionally designed to require more effort than others, such as those activating potentially dangerous machinery. But buttons we use every day, like an elevator call button, are usually designed to be as simple to use as possible.
Buttons are usually designed to be as simple to use as possible
Buttons are designed to take what the user is doing into account.
They include mechanisms that make for a better end-to-end user experience to carefully align function with the user's intent and mitigate the associated risk of inadvertently pushing the button.
For instance, if you want to force shutdown your computer, you'll need to press not one but three buttons—Control, Alt, Delete. In a similar fashion, it may only take the press of a button to start your car, but in many cases, you'll have to hold the brake pedal down simultaneously to make sure you don’t suddenly accelerate into traffic or a garage door.
Buttons are often designed to align function with the user’s intent
Form factor: shape, size, and materials
Many factors influence a button’s shape.
You may have noticed that certain buttons feel like second nature to operate, like the buttons on a computer mouse. While not particularly large or obtrusive, the shape, placement, and ease of clicking mean the user often doesn’t need to look at the buttons to know how they function, relying instead on their sense of touch and intuition.
Other buttons are made to be extremely large, allowing them to be pressed from a variety of angles. For example, a button to open a hospital door is very large and requires low push accuracy so that you can even press it with an elbow if you’re in a wheelchair or using crutches. A button’s use also dictates the material used in its construction. These can range from soft plastics for light usage to metal that allows the button to withstand heavy use or exposure to the elements.
Location, location, location
Where a button is placed can say a lot about a button’s intended use.
It’s not surprising that buttons are often placed where they can most easily be used. Take arcade games for instance. There’s a good reason buttons are placed on top of a joystick and on the sides of a pinball machine. It’s a location comfortable to the hand and suited for the task. Similarly, monitor buttons are often placed along the bottom where interacting with them does not block the screen.
Some buttons are easier to press than others.
While some buttons intended for repeated use are made to be easy to press, others can require more force to activate.
Patients should be trained by a healthcare professional prior to using Enbrel Mini® single-dose prefilled cartridge with AutoTouch® reusable autoinjector. This website is for informational purposes only. Detailed instructions are provided in the Instructions for Use. This site is intended for healthcare professionals only. If you are not a healthcare professional, please contact your doctor about ENBREL.
We wanted to create an injection device with an activation button specifically designed to meet the needs of RA and PsA patients
The button is placed at a slightly downward angle for easier accessibility.
Like a car that requires the brake pedal be pushed to start it, Enbrel Mini® with AutoTouch® has a skin sensor to confirm the user’s intent
Like the buttons on an elevator or a dishwasher, AutoTouch® only requires a simple press and release of the button for activation
Skin Sensor Confirmation
Press and release
Communicating key information
A BUTTON BUILT FOR RA AND PsA
Enbrel Mini® single-dose prefilled cartridge with AutoTouch® reusable autoinjector automates the injection process with a press and release of a button.
Cognizant of the needs of moderate to severe rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients, we set out to design an autoinjector with a button to help minimize the amount of force needed to activate it. A typical computer key takes approximately 13 newtons to activate while the Enbrel Mini® with AutoTouch® only takes a maximum of 5.56 newtons—that’s less than half the force of pressing a computer key! In fact, validation testing of 66 autoinjectors revealed that the actual amount of force needed was even lower, ranging from 1.7 to 2.9 newtons. And if you’re wondering if such a sensitive button could make misfires a problem, we thought of that too...
Skin Sensor Confirmation
Because the button requires such little force to press, we equipped Enbrel Mini® with AutoTouch® with a mechanism to help prevent accidental injections: a skin sensor that doesn’t allow the injection to proceed unless it detects that the device is in proper contact with the skin.
Research revealed that a button placed on the side of the device was challenging for those with larger hands. Thus, the button was placed at an angle at the top, giving patients the ability to trigger the device with their thumb. In addition, the flange around the button was minimized, enabling better accessibility.
The button on the Enbrel Mini® with AutoTouch® is tapered to allow for activation while reducing the need for the user to adjust their grip on the device. Find out how patients are getting a handle on grip with AutoTouch®.
OPERATING THE BUTTON
Besides its shape, placement, and the pressure required for activation, the button on the AutoTouch® was designed with other features to help patients successfully complete the injection process. See more features of AutoTouch® in action.
Press and release
There are plenty of buttons that aren’t required to be continuously held down in order to function. Instead, the buttons we use every day, such as garage door openers, elevator buttons, and dishwasher buttons, require only a quick press and release.
In the same way, the button on the Enbrel Mini® with AutoTouch® does not need to be held down throughout the injection process. Instead, a simple press and release of the button begins the injection.
Communicating key information
The button on the Enbrel Mini® with AutoTouch® also has several features that convey important information to the user throughout the injection process. Prior to the injection, a light in the button illuminates green, letting the user know that the device is ready to inject. During the injection, the light flashes, showing the user that the injection is in progress, and the green light stops when the injection is complete.
In addition to the button light, Enbrel Mini® with AutoTouch® has redundant communication features, such as an LCD progress bar on the side and an audio chime when the injection is complete. That way, the user has multiple feedback mechanisms throughout the injection process.
PURPOSE-BUILT FOR RA AND PsA PATIENTS
There's nothing simple about designing a simple button.
We thought about placement, shape, size, push pressure, and lighting so we could make a button suited for RA and PsA patients. Ultimately, the button on the AutoTouch® may seem inconsequential, yet it has a real-world impact on our RA and PsA patients—and that's what matters to us.
Get to know Enbrel Mini® single-dose prefilled cartridge with Autotouch® reusable autoinjector
Experience Enbrel Mini® with AutoTouch® in person and see how the simple press and release of a button can automate the injection process for your patients taking ENBREL.
Talk to your ENBREL representative or call 1-888-4ENBREL to schedule an in-person demo.
Important Safety Information and Indications
Patients treated with ENBREL are at increased risk for developing serious infections that may lead to hospitalization or death. Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids or were predisposed to infection because of their underlying disease. ENBREL should not be initiated in the presence of sepsis, active infections, or allergy to ENBREL or its components. ENBREL should be discontinued if a patient develops a serious infection or sepsis. Reported infections include: 1) Active tuberculosis (TB), including reactivation of latent TB. Patients with TB have frequently presented with disseminated or extrapulmonary disease. Patients should be tested for latent TB before ENBREL use and periodically during therapy. Treatment for latent infection should be initiated prior to ENBREL use, 2) Invasive fungal infections, including histoplasmosis, coccidioidomycosis, candidiasis, aspergillosis, blastomycosis, and pneumocystosis. Patients with histoplasmosis or other invasive fungal infections may present with disseminated, rather than localized, disease. Antigen and antibody testing for histoplasmosis may be negative in some patients with active infection. Empiric antifungal therapy should be considered in patients at risk for invasive fungal infections who develop severe systemic illness, and 3) Bacterial, viral, and other infections due to opportunistic pathogens, including Legionella and Listeria.
The risks and benefits of treatment with ENBREL should be carefully considered prior to initiating therapy in patients 1) with chronic or recurrent infection, 2) who have been exposed to TB, 3) who have resided or traveled in areas of endemic TB or endemic mycoses, or 4) with underlying conditions that may predispose them to infections such as advanced or poorly controlled diabetes. Patients should be closely monitored for the development of signs and symptoms of infection during and after treatment with ENBREL, including the possible development of TB in patients who tested negative for latent TB prior to initiating therapy.
Lymphoma and other malignancies, some fatal, have been reported in children and adolescent patients treated with tumor necrosis factor (TNF) blockers, including ENBREL.
In adult clinical trials of all TNF blockers, more cases of lymphoma were seen compared to control patients. The risk of lymphoma may be up to several-fold higher in RA patients. The role of TNF blocker therapy in the development of malignancies is unknown.
Cases of acute and chronic leukemia have been reported in association with postmarketing TNF blocker use in RA and other indications. The risk of leukemia may be higher in patients with RA (approximately 2-fold) than the general population.
Melanoma and non-melanoma skin cancer (NMSC) have been reported in patients treated with TNF blockers, including ENBREL. Periodic skin examinations should be considered for all patients at increased risk for skin cancer.
In patients who initiated therapy at ≤18 years of age, approximately half of the reported malignancies were lymphomas (Hodgkin’s and non-Hodgkin’s lymphoma). Other cases included rare malignancies usually associated with immunosuppression and malignancies that are not usually observed in children and adolescents. Most of the patients were receiving concomitant immunosuppressants.
Treatment with TNF-blocking agents, including ENBREL, has been associated with rare (<0.1%) cases of new onset or exacerbation of central nervous system demyelinating disorders, some presenting with mental status changes and some associated with permanent disability, and with peripheral nervous system demyelinating disorders. Cases of transverse myelitis, optic neuritis, multiple sclerosis, Guillain-Barré syndromes, other peripheral demyelinating neuropathies, and new onset or exacerbation of seizure disorders have been reported in postmarketing experience with ENBREL therapy. Prescribers should exercise caution in considering the use of ENBREL in patients with preexisting or recent-onset central or peripheral nervous system demyelinating disorders.
CONGESTIVE HEART FAILURE
Cases of worsening congestive heart failure (CHF) and, rarely, new-onset cases have been reported in patients taking ENBREL. Caution should be used when using ENBREL in patients with CHF. These patients should be carefully monitored.
Rare cases of pancytopenia, including aplastic anemia, some fatal, have been reported. The causal relationship to ENBREL therapy remains unclear. Exercise caution when considering ENBREL in patients who have a previous history of significant hematologic abnormalities. Advise patients to seek immediate medical attention if they develop signs or symptoms of blood dyscrasias or infection. Consider discontinuing ENBREL if significant hematologic abnormalities are confirmed.
HEPATITIS B REACTIVATION
Reactivation of hepatitis B has been reported in patients who were previously infected with hepatitis B virus (HBV) and received concomitant TNF-blocking agents, including ENBREL. Most reports occurred in patients also taking immunosuppressive agents, which may contribute to hepatitis B reactivation. Exercise caution when considering ENBREL in these patients.
Allergic reactions associated with administration of ENBREL during clinical trials have been reported in <2% of patients. If an anaphylactic reaction or other serious allergic reaction occurs, administration of ENBREL should be discontinued immediately and appropriate therapy initiated.
Live vaccines should not be administered to patients on ENBREL. Pediatric patients, if possible, should be brought up to date with all immunizations prior to initiating ENBREL. In patients with exposure to varicella virus, temporarily discontinue ENBREL and consider prophylactic treatment with Varicella Zoster Immune Globulin.
Autoantibodies may develop with ENBREL, and rarely lupus-like syndrome or autoimmune hepatitis may occur. These may resolve upon withdrawal of ENBREL. Stop ENBREL if lupus-like syndrome or autoimmune hepatitis develops.
WEGENER’S GRANULOMATOSIS PATIENTS
The use of ENBREL in patients with Wegener’s granulomatosis receiving immunosuppressive agents (eg, cyclophosphamide) is not recommended.
MODERATE TO SEVERE ALCOHOLIC HEPATITIS
Based on a study of patients treated for alcoholic hepatitis, exercise caution when using ENBREL in patients with moderate to severe alcoholic hepatitis.
The most commonly reported adverse reactions in RA clinical trials were injection site reaction and infection. In clinical trials of all other adult indications, adverse reactions were similar to those reported in RA clinical trials.
In general, the adverse reactions in pediatric patients were similar in frequency and type as those seen in adult patients. The types of infections reported in pediatric patients were generally mild and consistent with those commonly seen in the general pediatric population.
The use of ENBREL in patients receiving concurrent cyclophosphamide therapy is not recommended. The risk of serious infection may increase with concomitant use of abatacept therapy. Concurrent therapy with ENBREL and anakinra is not recommended. Hypoglycemia has been reported following initiation of ENBREL therapy in patients receiving medication for diabetes, necessitating a reduction in anti-diabetic medication in some of these patients.
ENBREL is indicated for reducing signs and symptoms, inducing major clinical response, inhibiting the progression of structural damage, and improving physical function in patients with moderately to severely active rheumatoid arthritis. ENBREL can be initiated in combination with methotrexate (MTX) or used alone.
ENBREL is indicated for the treatment of patients 4 years or older with chronic moderate to severe plaque psoriasis (PsO) who are candidates for systemic therapy or phototherapy.
ENBREL is indicated for reducing signs and symptoms, inhibiting the progression of structural damage of active arthritis, and improving physical function in patients with psoriatic arthritis (PsA). ENBREL can be used with or without MTX.
ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.
ENBREL is indicated for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis in patients ages 2 and older.