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Correlation of patient preferences to treatment outcomes in patients with rheumatoid arthritis treated with tumour necrosis factor inhibitors in Greece

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Abstract

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.

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Acknowledgements

The authors would like to thank Drs Andrianakos Alexandros† (deceased), Fragiadaki Kalliopi, Georgiadis Athanasios, Kakavouli-Giokic Giasna, Theodoridou Athina, Vlachogiannopoulos Panagiotis, Kontogianni Anastasia, Kotrotsios Anastasios, Triantafyllidou Eva, Georgiou Panagiotis, Gazi Soussana, Boura Panagiota and Tsifetaki Nicky for their active contribution in the conduct of this study.

Funding

This study was sponsored by Merck Sharp & Dohme (MSD) Greece.

Author information

Authors and Affiliations

  1. Department of Rheumatology, Clinical Immunology and Allergy, Medical School, University of Crete, Heraklion, Greece

    Prodromos Sidiropoulos

  2. Private Practice, Patras, Greece

    Andreas Bounas

  3. Rheumatology Division, General Hospital of Thessaloniki St. Paul, Thessaloniki, Greece

    Panagiotis Athanassiou

  4. Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, 2nd Department of Medicine and Laboratory, National and Kapodistrian University of Athens, School of Medicine, Hippokration General Hospital, 114 Vass. Sophias Ave, 115 27, Athens, Greece

    Christos Koutsianas & Dimitrios Vassilopoulos

  5. Medical Department, MSD, Athens, Greece

    Evangelia Petrikkou

  6. Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece

    Evripidis Kaltsonoudis & Alexandros Drosos

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  1. Prodromos Sidiropoulos
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  8. Dimitrios Vassilopoulos
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Correspondence to Dimitrios Vassilopoulos.

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Conflict of interest

Evangelia Petrikou was employed by Merck Sharp & Dohme (MSD) Greece. All other authors declare no competing interests.

Ethical approval was provided by the local institutional boards of participating centres, and informed consent was provided by all patients before their inclusion in the study and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Sidiropoulos, P., Bounas, A., Athanassiou, P. et al. Correlation of patient preferences to treatment outcomes in patients with rheumatoid arthritis treated with tumour necrosis factor inhibitors in Greece. Clin Rheumatol 39, 3643–3652 (2020). https://doi.org/10.1007/s10067-020-05171-8

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  • DOI: https://doi.org/10.1007/s10067-020-05171-8

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