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

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). Electronic Supplementary Material The online version of this article (10.1007/s40744-019-00168-5) contains supplementary material, which is available to authorized users.

Factors associated with treatment satisfaction in patients with rheumatoid arthritis: data from the biological register RABBIT

“…The high patient satisfaction in treated RA is in line with former evidence 1 6 but much higher than in the current data of a US web-based survey. 10 This study used the Treatment Satisfaction Questionnaire for Medication (TSQM) as an instrument for measuring satisfaction 11 resulting in only 26% of the responders being satisfied with their RA therapy (67% reporting to receive bDMARDs). Besides a more specific assessment of satisfaction, this cross-sectional survey represented an unselected outpatient collective with self-reported RA.…”

“…Besides a more specific assessment of satisfaction, this cross-sectional survey represented an unselected outpatient collective with self-reported RA. 10 Patients enrolled in RABBIT are all in rheumatology care, closely monitored and familiar with the use of questionnaires which may explain differences in the results.…”

Treatment Satisfaction, Patient Preferences, and the Impact of Suboptimal Disease Control in a Large International Rheumatoid Arthritis Cohort: SENSE Study

“…The primary outcome was patients’ RA treatment satisfaction, which was assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM; v1.4). 15 The TSQM provides a validated score for four subscales: effectiveness, side effects, convenience, and global satisfaction. Good treatment satisfaction was defined as a global satisfaction score ≥80 out of a possible 100.…”

Kinase inhibition in autoimmunity and inflammation

“…However, there are still considerable unmet medical needs for the treatment of some inflammatory (COPD, IPF and IBD) and autoimmune (SLE, type 1 diabetes, primary biliary cirrhosis, Graves disease and multiple sclerosis) diseases, indicating the demand for effective therapeutics 5 . Even for diseases such as RA, for which several approved drugs exist, 74% of patients are not satisfied with their current treatment, according to surveys 8 . Thus, availability of effective treatments with disease-modifying potential and minimal adverse effects to reset productive immunity is crucial.…”