TY - JOUR
TI - Correlation of patient preferences to treatment outcomes in patients with rheumatoid arthritis treated with tumour necrosis factor inhibitors in Greece
AU - Sidiropoulos, P.
AU - Bounas, A.
AU - Athanassiou, P.
AU - Koutsianas, C.
AU - Petrikkou, E.
AU - Kaltsonoudis, E.
AU - Drosos, A.
AU - Vassilopoulos, D.
JO - Bailliere's Clinical Rheumatology
PY - 2020
VL - 39
TODO - 12
SP - 3643-3652
PB - Springer Science and Business Media Deutschland GmbH
SN - 0950-3579
TODO - 10.1007/s10067-020-05171-8
TODO - adalimumab;  certolizumab pegol;  corticosteroid;  disease modifying antirheumatic drug;  etanercept;  golimumab;  hydroxychloroquine;  infliximab;  leflunomide;  methotrexate;  nonsteroid antiinflammatory agent;  tumor necrosis factor inhibitor;  antirheumatic agent;  tumor necrosis factor;  tumor necrosis factor inhibitor, adult;  Article;  attitude to health;  clinical outcome;  cohort analysis;  comorbidity;  DAS28;  disease duration;  drug safety;  drug tolerability;  drug withdrawal;  female;  follow up;  Greece;  human;  major clinical study;  male;  middle aged;  multicenter study;  patient compliance;  patient preference;  patient satisfaction;  patient-reported outcome;  priority journal;  prospective study;  remission;  rheumatoid arthritis;  shared decision making;  survival rate;  swollen joint count;  tender joint count;  treatment response;  patient preference;  treatment outcome, Antirheumatic Agents;  Arthritis, Rheumatoid;  Cohort Studies;  Greece;  Humans;  Patient Preference;  Prospective Studies;  Treatment Outcome;  Tumor Necrosis Factor Inhibitors;  Tumor Necrosis Factor-alpha
TODO - Objectives: To investigate possible associations between rheumatoid arthritis (RA) patient-expressed preferences over anti-tumour necrosis factor (anti-TNF) treatment and clinical and patient-reported outcomes. Methods: PANORAMA was a non-interventional, prospective, multicentre, cohort study of 12 months duration, in patients with moderate-to-severe RA who initiated or switched to anti-TNF treatment. After initiation of anti-TNF, patients completed a preferences questionnaire on attributes related to anti-TNF treatment. Satisfaction with treatment was assessed with the Treatment Satisfaction Questionnaire for Medication (TSQM); compliance and persistence to treatment were recorded via a patient diary. Univariate and multivariate analyses were applied to assess correlations between patients’ preferences over treatment with clinical and patient-reported outcomes. Results: A total of 254 patients were enrolled; 66.1% (168/254) had highly active disease (DAS28-ESR > 5.1), while 65.4% (166/254) were biological-naïve. The 12-month drug-survival rate was 72.3%, while the respective rates of good EULAR response and remission (DAS28-ESR < 2.6) were 56.5% and 40.8%, respectively. By univariate analysis, fulfilment of patient preferences over treatment was associated with increased probability of remaining on therapy (p = 0.019), good EULAR response (p < 0.001) and satisfaction with treatment (p < 0.001). By multivariate analysis, fulfilment of patient preferences was the most important predictor for good EULAR response (OR 5.56, p < 0.001; finding confirmed and after propensity scoring matching), while seropositivity (HR 1.18, p = 0.047) and a high ESR (> 35 mm/h, HR 1.16, p = 0.071) predicted drug survival. Conclusions: In anti-TNF-treated RA patients, fulfilment of treatment preferences was independently associated with a good EULAR response and correlated with drug persistence at 12 months, emphasising the importance of patient preferences in treatment outcomes.Key Points• In anti-TNF treated RA patients, fulfilment of patients’ treatment preferences is associated with a good clinical response at 12 months.• A shared decision-making process can maximise treatment’s outcome in anti-TNF treated patients. © 2020, International League of Associations for Rheumatology (ILAR).
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