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Original research
Factors associated with treatment satisfaction in patients with rheumatoid arthritis: data from the biological register RABBIT
  1. Martin Schäfer1,
  2. Katinka Albrecht1,
  3. Jörn Kekow2,
  4. Karin Rockwitz3,
  5. Anke Liebhaber4,
  6. Angela Zink1 and
  7. Anja Strangfeld1
  1. 1 Epidemiology and Health Care Research, German Rheumatism Research Center (DRFZ Berlin), Berlin, Germany
  2. 2 Otto-von-Guericke University Magdeburg, Clinic of Rheumatology and Orthopaedics, Vogelsang-Gommern, Germany
  3. 3 Rheumatologic Practice, Goslar, Germany
  4. 4 Rheumatologic Practice, Halle, Germany
  1. Correspondence to Martin Schäfer;martin.schaefer{at}drfz.de

Abstract

Objective To assess satisfaction with the effectiveness and tolerability of treatments in patients with rheumatoid arthritis (RA).

Methods Patients from the RABBIT register, starting a biological (b) or targeted synthetic (ts) disease-modifying antirheumatic drug (DMARD), or a conventional synthetic (cs)DMARD treatment after ≥1 csDMARD failure, were included. Treatment satisfaction was measured after 1 year of treatment in four categories and binarised for analysis. Logistic regression models were performed to calculate ORs for factors associated with treatment satisfaction.

Results Data of 10 646 patients (74% women, mean 58 years) were analysed. At baseline, 55% of the patients were satisfied with the efficacy and 68% with the tolerability of their previously given treatments. After 1 year, 85% of the patients were satisfied with treatment effectiveness and 90% with tolerability. Baseline satisfaction (OR 2.98, 95% CI 2.58 to 3.44), seropositivity (OR 1.36, 95% CI 1.17 to 1.57), reduction of DAS28 (OR 1.38, 95% CI 1.31 to 1.46) and pain (OR 1.26, 95% CI 1.22 to 1.31), and the improvement of physical capacity (OR 1.22, 95% CI 1.17 to 1.29) were positively associated with treatment satisfaction at follow-up while glucocorticoids (GCs) >5 mg/day, depression, fibromyalgia, obesity, prior bDMARDs and therapy changes were negatively associated. The impact of GC on satisfaction was dose-dependent, becoming strongest for GC >15 mg (OR 0.24, 95% CI 0.16 to 0.34). A 5 mg/day reduction within 12 months was positively associated with satisfaction regarding efficacy (OR 1.19, 95% CI 1.11 to 1.27) and tolerability (OR 1.11, 95% CI 1.03 to 1.21).

Conclusion Most patients were satisfied with their treatment’s effectiveness and tolerability after 1 year of treatment. Tapering GCs was positively associated with the improvement of patients’ satisfaction.

  • Arthritis
  • Rheumatoid
  • Biological Therapy
  • Patient Reported Outcome Measures
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Footnotes

  • Contributors All authors have given a substantial contribution to one or more of the following aspects of the manuscript: conception and design, acquisition, analysis and interpretation of the data, drafting and revising the manuscript.

  • Funding RABBIT is supported by a joint, unconditional grant from AbbVie, Amgen, Bristol-Myers Squibb, Celltrion, Fresenius Kabi, Hexal, Lilly, MSD Sharp & Dohme, Mylan, Pfizer, Roche, Samsung Bioepis, Sanofi-Aventis and UCB. Role of the funding source: the principal investigators and their team had full academic freedom in study design and conduct, data analysis and publication of results. These stipulations were delineated in their contract with the sponsors. For the purpose of information, all funding companies received the manuscript 30 days prior to submission. Publication of this article was not contingent on their approval. The data interpretation, drafting, critical revision and approval of the final manuscript were performed solely by the authors.

  • Competing interests AS has received speaking fees from Bristol-Myers Squibb, MSD Sharp & Dome, Pfizer and Roche. AZ has received speaking fees from AbbVie, Janssen, Pfizer, Roche and Sanofi-Aventis. All other authors have declared no competing interests.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was obtained from the Ethics Committee of the Charité-Universitätsmedizin Berlin, Berlin.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No additional data are available.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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