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. 2019 Sep;6(3):461-471.
doi: 10.1007/s40744-019-00168-5. Epub 2019 Aug 6.

Patient Perceptions of Unmet Medical Need in Rheumatoid Arthritis: A Cross-Sectional Survey in the USA

Christine Radawski  1 , Mark C Genovese  2 , Brett Hauber  3 , W Benjamin Nowell  4 , Kelly Hollis  3 , Carol L Gaich  5 , Amy M DeLozier  5 , Kelly Gavigan  4 , Maria Reynolds  3 , Anabela Cardoso  5 , Jeffrey R Curtis  6
Affiliations

Patient Perceptions of Unmet Medical Need in Rheumatoid Arthritis: A Cross-Sectional Survey in the USA

Christine Radawski et al. Rheumatol Ther. 2019 Sep.

Abstract

Introduction: Many rheumatoid arthritis (RA) patients do not achieve their treatment goals and experience symptoms that affect psychosocial outcomes and daily activities. This study aimed to identify and quantify the unmet needs perceived by US patients with RA currently taking a disease-modifying antirheumatic drug (DMARD).

Methods: A cross-sectional, web-based survey was conducted with RA patients recruited through CreakyJoints, an online patient support community, and ArthritisPower®, an online patient research registry, from December 2017 to January 2018. Participant patients were aged ≥ 21 years, failed ≥ 1 DMARDs, and were receiving their current DMARD(s) for ≥ 6 months; they answered 50 questions about treatment history, RA symptoms, and flares and completed the Rheumatoid Arthritis Impact of Disease (RAID) questionnaire and the Treatment Satisfaction Questionnaire for Medication (TSQM). Treatment satisfaction was defined by a TSQM global satisfaction score ≥ 80.

Results: Of 415 patients screened, 258 (62%) were eligible and completed the survey; 87% were women, and 87% white, with mean (SD) age of 54.5 (11.4) years. A total of 232 patients (90%) had current or past biologic DMARD (bDMARD) use, with 67% currently on a bDMARD, 65% on ≥ 1 conventional synthetic DMARD, and 40% on methotrexate. Forty-three percent of patients reported daily/almost daily use of prescription pain medications, and 44% reported a current flare. Mean (SD) TSQM scores were 59 [20] for effectiveness, 59 [26] for side effects, 72 [18] for convenience, and 65 [21] for global satisfaction. The mean (SD) RAID overall score was 5.1 (2.0) on a 0-10 scale. Only 26% (67 patients) were satisfied with their RA treatment. Patients not satisfied with treatment reported higher RAID scores overall and by domain, and approximately half reported a current flare.

Conclusions: Results from this real-world survey suggest that three-fourths of RA patients are not satisfied with treatments, which include bDMARDs. Patients continued to experience bothersome symptoms that impacted their daily activities and life. There remains a need for improved disease management among currently treated RA patients.

Funding: Eli Lilly and Company (Indianapolis, IN, USA).

Keywords: Patient-reported outcomes; Rheumatoid arthritis; Satisfaction; Survey research; Unmet need.

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Conflict of interest statement

Christine Radawski is an employee of Eli Lilly and Company. Carol L. Gaich is an employee of Eli Lilly and Company. Amy M. DeLozier is an employee of Eli Lilly and Company. Anabela Cardoso is an employee of Eli Lilly and Company. Mark C. Genovese has received grant/research support and has provided expert advice to Eli Lilly and Company and Novartis. Brett Haube has received grant/research support from Eli Lilly and Company. W. Benjamin Nowell has received grant/research support from Eli Lilly and Company. Kelly Hollis has received grant/research support from Eli Lilly and Company. Kelly Gavigan has received grant/research support from Eli Lilly and Company. Maria Reynolds has received grant/research support from Eli Lilly and Company. Jeffrey R. Curtis has received grant/research support and provided expert advice to AbbVie, Amgen, BMS, Corrona, Eli Lilly and Company, Janssen, Myriad, were consistent with the patient populations that appear in the literature Pfizer, Regeneron, Roche and UCB.

Figures

Fig. 1
Fig. 1
Frequency of Rheumatoid Arthritis Impact of Disease (RAID) final scores. LDA low disease activity, PASS patient acceptable symptom state
Fig. 2
Fig. 2
Mean Rheumatoid Arthritis Impact Of Disease (RAID) score overall and by domain and flare status, stratified by patient treatment satisfaction [defined as treatment satisfaction questionnaire for medication (TSQM) global satisfaction score ≥ 80]. Twenty-six percent (n = 67) were classified as being satisfied with treatment and 74% (n = 188) as unsatisfied
Fig. 3
Fig. 3
Percentage of patients reporting moderate-to-severe symptoms and impacts
See this image and copyright information in PMC

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