<p>Clinical Outcomes of Patients with Rheumatoid Arthritis Treated in a Disease Management Program: Real-World Results</p>

Abstract

Background: Care models can affect the clinical outcome of patients with rheumatic and musculoskeletal diseases. Objective: We aimed to compare how an innovative model of a rheumatoid arthritis disease-management program can improve the clinical outcomes of patients compared to a conventional assessment approach. Methods: We performed a retrospective analysis of real-world data from clinical records of a cohort of 5078 patients diagnosed with rheumatoid arthritis who were followed up at the Center of Excellence in Rheumatoid Arthritis vs the clinical outcomes reported in the Colombian National Registry of Rheumatoid Arthritis. Results: We found significant differences in the diagnosis and follow-up between the specialized Center program and the usual care reported by the Colombian National Registry (p<0.005), including the evaluation of rheumatoid factor, Anti-citrullinated antibodies Disease Activity Score, Health Assessment Questionnaire, number of visits to the rheumatologist, and clinical outcomes measured by the level of disease activity. In addition, when comparing the Center's clinical outcomes-from baseline to the last follow-up, we found an improvement in the level of disease activity, with patients classified in remission increasing from 20.8% to 58.5% (p<0.005), and a reduction in those with high disease activity from 18% to 4.7% (p<0.005). Conclusion: Real-world evidence showed that patients with rheumatoid arthritis who underwent follow-up under an innovative disease-management model improved their clinical outcomes compared with those patients in a conventional assessment program. These results could suggest a way of improving health policies for patients with rheumatoid arthritis.

Demographic and Clinical Characteristics of Patients with Sustained and Switching Treatments Using Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs: A Multicenter, Observational Cross-Sectional Study for Rheumatoid Arthritis

“…A well-known fact is that middle to older-aged individuals with female predominance are the most frequent patient group affected by RA. Our findings were comparable to these well-established features of RA [ 3 , 5 , 11 , 17 , 25 , 26 ]. Ageing is essential for developing higher risks and hospitalizations associated with comorbidities [ 25 , 27 ].…”

“…Our findings were comparable to these well-established features of RA [ 3 , 5 , 11 , 17 , 25 , 26 ]. Ageing is essential for developing higher risks and hospitalizations associated with comorbidities [ 25 , 27 ]. The mean age of the patients and the distribution of the comorbid diseases in each group were similar in the current study as Bawazir’s study [ 17 ].…”

“…The remission rates based on the DAS28-CRP in the large-scale studies of RA are approximately 40%, contrary to higher rates reported by others [11,17,25,32]. We found that 35.5% of all patients had disease remission.…”

Predictors of Remission and Low Disease Activity in Rheumatoid Arthritis Patients

“…[17][18][19][20][21] Furthermore, the increase in the remission rates over time that we observed is still considered quite inadequate. 10,[22][23][24][25] Explanations that come to mind include our patient's low accessibility to b/ts-DMARDs, their relative long disease duration, 26 and/or a delay in the implementation of an adequate tight control strategy. In addition, the use of the SDAI in our cohort, stricter in comparison with the 28-joint count disease activity score, 27 which has been used in the majority of RA LA cohorts published (see supplementary table), could partially explain the low remission rates we observed in our patients.…”

Relationship between care model and disease activity states and health-related quality of life in systemic lupus erythematosus patients

“…In contrast, patients cared for at this center exhibited lower levels of disease activity, a high proportion of them were classified as being in remission while a low proportion exhibited high disease activity. 4 In Chicago, Arora et al 3 compared the care received by SLE patients in two settings-a Lupus Clinic (LC) and a General Rheumatology Clinic (GRC) within the same academic institution. They showed that care provided at the LC or who were seen by rheumatologists with a high volume of SLE patients provided a better quality of care (including sunscreen and drug counseling, vaccination, use of steroid-sparing agents, cardiovascular disease risk assessment, among others) than the one provided at the GRC.…”