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Patients' perceptions of unmet medical need in rheumatoid arthritis
Curtis, J. L., Genovese, M., Hauber, A. B., Nowell, W. B., Hollis, K. A., Gaich, C., DeLozier, A., Gavigan, K., & Cardoso, A. (2018). Patients' perceptions of unmet medical need in rheumatoid arthritis. Pharmacoepidemiology and Drug Safety, 27(S2), Article 116. https://doi.org/10.1002/pds.4629
Background: Despite many available treatments for rheumatoid arthritis (RA), a considerable proportion of patients do not achieve their treatment goals. Some RA patients continue to experience symptoms, such as pain and diminished function that may affect their psychosocial outcomes and activities of daily living.
Objectives: To identify, characterize, and quantify the unmet needs of patients with RA in the United States currently taking a disease‐modifying antirheumatic drug (DMARD).
Methods: A cross‐sectional, web‐based survey was conducted with RA patients who were identified and recruited through CreakyJoints, an online patient support community, and ArthritisPower, an online patient research registry, from 12/2017 to 1/2018. Eligible patients were aged ≥21 years, reported a diagnosis of RA, and failed ≥1 DMARDs and were receiving their current DMARD medication(s) for ≥6 months. Patients answered 50 questions about treatment history, RA symptoms, disease‐related impacts using the Rheumatoid Arthritis Impact of Disease (RAID), flares, and treatment satisfaction using the Treatment Satisfaction Questionnaire for Medication (TSQM). Descriptive analyses were used to summarize the responses.
Results: Of 415 patients screened, 258 (62%) were eligible and completed the survey. Patients were predominantly female (87%) and Caucasian (87%), with a mean (SD) age of 54.5 (11.4) years. In total, 232 (90%) had current or past experience with a biologic, with 67% currently on a biologic, 71% on at least one conventional synthetic DMARD, and 40% on methotrexate. While almost half (46%) of patients were satisfied‐to‐extremely satisfied with the way their medication relieves their symptoms, the study sample reported a mean (SD) RAID score of 5.06 (2.0) on a scale from 0 to 10, with higher scores indicating worse status. Overall, 67% of patients reported moderate‐to‐severe pain, 61% reported difficulty with daily physical activities, and 74% reported moderate to severe fatigue because of their RA in the prior 7 days. 43% of patients reported daily or almost daily use of prescription treatments for pain relief and 44% of patients reported a current flare in their RA.
Conclusions: Results from this real‐world sample of RA patients indicate that although patients tend to report satisfaction with their treatment, many continue to experience bothersome symptoms (eg, pain and impaired physical function). Despite many available RA therapies, these results suggest that there remains significant unmet need for RA patients on current approved treatments.
