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. 2018 Mar 17;4(1):e000615.
doi: 10.1136/rmdopen-2017-000615. eCollection 2018.

Clinical characteristics and patient-reported outcomes in patients with inadequately controlled rheumatoid arthritis despite ongoing treatment

Peter C Taylor  1 , Rieke Alten  2 , Juan J Gomez-Reino  3 , Roberto Caporali  4 , Philippe Bertin  5 , Emma Sullivan  6 , Robert Wood  6 , James Piercy  6 , Radu Vasilescu  7 , Dean Spurden  8 , Jose Alvir  9 , Miriam Tarallo  10
Affiliations

Clinical characteristics and patient-reported outcomes in patients with inadequately controlled rheumatoid arthritis despite ongoing treatment

Peter C Taylor et al. RMD Open. .

Abstract

Background: Despite the wide array of treatments available for rheumatoid arthritis (RA), some patients continue to report unmet clinical needs. We investigated the extent of inadequate disease control in patients with RA.

Methods: Data were drawn from the Adelphi 2014 RA Disease-Specific Program in France, Germany, Italy, Spain and the UK. Rheumatologists provided patient demographics, comorbidities, satisfaction with RA control and other clinical details. Patients reported their level of satisfaction and completed the EuroQoL 5-Dimensions Health Questionnaire and Work Productivity and Activity Impairment Questionnaire. Patients had been on their current therapy ≥3 months and had 28-joint disease activity scores (DAS28) reported. Adequately controlled (DAS28 ≤3.2) and inadequately controlled (DAS28 >3.2) patient cohorts were compared using univariate tests.

Results: Of 1147 patients, 74% were women, the mean age was 52 years and the mean time since RA diagnosis was 7 years. Twenty-seven percent of patients had inadequately controlled RA, whereas 73% had adequately controlled RA. Inadequately controlled patients were more affected clinically versus adequately controlled patients; 69% vs 13% had moderate/severe RA, the current level of pain was 4.6 vs 2.3, and 67% vs 41% experienced flares, respectively (all p<0.0001). Inadequately controlled patients had higher rates of depression (16% vs 5%; p<0.0001), worse health state, greater work and activity impairment, and lower satisfaction rates among the patients and their physicians than the adequately controlled cohort.

Conclusion: RA was insufficiently controlled in over a quarter of patients despite their current therapy and this had a negative impact on the patients.

Keywords: dmards (biologic); patient perspective.

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Conflict of interest statement

Competing interests: PCT has received fees from AbbVie, Bristol-Myers Squibb, Janssen, Lilly, Merck, Pfizer, Sandoz, Biogen and UCB Pharma. RA has received fees from Pfizer. JJGR has received fees from AbbVie, Biogen, Bristol-Myers Squibb, Hospira, Janssen, Merck, Pfizer, Regeneron and UCB Pharma. RC has received fees from AbbVie, MSD, Pfizer, Roche and UCB Pharma. PB has received fees from MSD, Pfizer, Reckitt Benckiser and Roche. ES, RW and JP are employees of Adelphi Real World and were contracted by Pfizer to provide data, input into design of data collection and statistical support for the development of this paper. RV, DS, JA and MT are employees of Pfizer.

Figures

Figure 1
Figure 1
Flow of participants. DAS28, disease activity score in 28 joints; PRF, patient record form; PSC, patient self-completion form.
Figure 2
Figure 2
Patient-reported outcomes. (A) EQ-5D (B) WPAI. P values were calculated using the Mann-Whitney U test. DAS28, disease activity score in 28 joints; EQ-5D, EuroQoL 5-Dimensions; WPAI, Work Productivity and Activity Impairment.
Figure 3
Figure 3
Satisfaction with control of RA. (A) Physician-reported satisfaction, (B) Patient-reported satisfaction. p values were calculated using the Mann-Whitney U test. DAS28, disease activity score in 28 joints; RA, rheumatoid arthritis.
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References

    1. Gibofsky A. Overview of epidemiology, pathophysiology, and diagnosis of rheumatoid arthritis. Am J Manag Care 2012;18(Suppl):S295–302. - PubMed
    1. Smolen JS, Landewé R, Bijlsma J, et al. . EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis 2017;76:960–77. 10.1136/annrheumdis-2016-210715 - DOI - PubMed
    1. Smolen JS, Landewé R, Breedveld FC, et al. . EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis 2014;73:492–509. 10.1136/annrheumdis-2013-204573 - DOI - PMC - PubMed
    1. Singh JA, Saag KG, Bridges SL, et al. . 2015 American college of rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol 2016;68:1–26. 10.1002/art.39480 - DOI - PubMed
    1. Pincus T, Sokka T, Kautiainen H. Patients seen for standard rheumatoid arthritis care have significantly better articular, radiographic, laboratory, and functional status in 2000 than in 1985. Arthritis Rheum 2005;52:1009–19. 10.1002/art.20941 - DOI - PubMed