Lower education and living in countries with lower wealth are associated with higher disease activity in rheumatoid arthritis: results from the multinational COMORA study

Putrik, Polina; Smolen, Josef S; Keszei, András; Hmamouchi, Ihsane; Dougados, Maxime; Uhlig, Till; Kvien, Tore K; Boonen, Annelies

doi:10.1136/annrheumdis-2014-206737

Cited by 65 publications

(63 citation statements)

References 20 publications

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“…But reality is more complicated. The effectiveness of bDMARD-usage in countries’ all-day clinical practice may be overstated: previous research estimated that ‘only’ 7% of the effect of GDP per capita on DAS28 was mediated by the uptake of bDMARDs 4. We found ‘only’ 2.8% more patients in DAS28-remission for every additional 10% patients using a bDMARD.…”

Section: Discussionmentioning

confidence: 57%

Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide: results from the METEOR-registry

et al. 2018

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ObjectiveTo establish in a global setting the relationships between countries’ socioeconomic status (SES), measured biological disease modifying antirheumatic drug (bDMARD)-usage and disease outcomes. To assess if prescription and reimbursement rules and generic access to medication relates to a countries’ bDMARD-usage.MethodsData on disease activity and drug use from countries that had contributed at least 100 patients were extracted from the METEOR database. Mean disease outcomes of all available patients at the final visit were calculated on a per-country basis. A questionnaire was sent to at least two rheumatologists per country inquiring about DMARD-prices, access to treatment and valid regulations for prescription and reimbursement.ResultsData from 20 379 patients living in 12 different countries showed that countries’ SES was positively associated with measured disease activity (meanDAS28), but not always with physical functioning (HAQ-score). A lower country’s SES, stricter rules for prescription and reimbursement of bDMARDs as well as worse affordability of bDMARDs were associated with lower bDMARD-usage. bDMARD-usage was negatively associated with disease activity (although not with physical functioning), but the association was moderate at best.ConclusionsDisease activity in patients with rheumatoid arthritis as well as bDMARD-usage varies across countries worldwide. The (negative) relationship between countries’ bDMARD-usage and level of disease activity is complex and under the influence of many factors, including—but not limited to—countries’ SES, affordability of bDMARDs and valid prescription and reimbursement rules for bDMARDs.

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Section: Discussionmentioning

confidence: 57%

Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide: results from the METEOR-registry

et al. 2018

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“…7 In fact, several studies have shown that living in countries with higher wealth is associated with lower RA disease activity. [13][14][15] This might be due, in part, to differences in types of concomitant therapies used, but the results from the global GO-MORE population did not reveal an effect of DMARD type or concomitant corticosteroid use on RA disease activity. 8 Better quality of care might also lead to higher patient expectations and therefore better responses to treatment.…”

Section: Fundingcontrasting

confidence: 48%

Efficacy of golimumab in Belgian patients with active rheumatoid arthritis despite treatment with non-biologic disease-modifying anti-rheumatic drugs: sub-analysis of the GO-MORE study

Durez

Vanthuyne

Soyfoo

et al. 2017

Acta Clinica Belgica

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“…Este hallazgo se corroboró con los reportes que muestran una prevalencia alta en el género femenino, asociada con las características hormonales y genéticas propias de la mujer, las cuales hacen que las enfermedades autoinmunes sean más frecuentes en ellas (22)(23)(24).…”

Section: Discussionunclassified

Calidad de vida, nivel de salud percibido y factores sociodemográficos en personas con artritis reumatoide

Gómez-Ramírez¹,

Ramírez²

2017

Aquichan

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Objetivo: determinar la relación entre la calidad de vida, el nivel de salud y los factores sociodemográficos en personas con artritis reumatoide (AR). Materiales y método: estudio correlacional explicativo. Se realizó una entrevista directa en el momento de la consulta de enfermería antes del control médico de reumatología. A través de un muestreo intencional no probabilístico de sujetos tipo se contó con la participación de 635 personas. Resultados: se encontró una frecuencia de presentación de AR mayor en mujeres (87%). También se evidenció una correlación positiva (0,596; P<0,001) entre calidad de vida y nivel de salud. Sociodemográficamente, las mujeres con educación básica y bajo estrato socioeconómico presentan una menor percepción de calidad de vida y nivel de salud. Estas variables se sometieron a un proceso de prueba con el uso de un modelo Path de análisis de covarianza. Conclusiones: las condiciones sociales que viven las personas con AR son factores que determinan la puesta en marcha de acciones de intervención dirigidas a solucionar la problemática de la calidad de vida en esta población.

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Lower education and living in countries with lower wealth are associated with higher disease activity in rheumatoid arthritis: results from the multinational COMORA study

Abstract: Female gender and lower individual or country SES were independently associated with DAS28, but did not reinforce each other. The association between lower individual SES (education) or lower country welfare (GDP) with higher DAS28 was partially mediated by uptake of bDMARDs.

Cited by 65 publications

References 20 publications

Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide: results from the METEOR-registry

Inequity in access to bDMARD care and how it influences disease outcomes across countries worldwide: results from the METEOR-registry

Efficacy of golimumab in Belgian patients with active rheumatoid arthritis despite treatment with non-biologic disease-modifying anti-rheumatic drugs: sub-analysis of the GO-MORE study

Calidad de vida, nivel de salud percibido y factores sociodemográficos en personas con artritis reumatoide

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