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Rheumatoid arthritis patients viewed combination DMARDs favorably
Patients with rheumatoid arthritis expressed generally favorable impressions of combination disease-modifying antirheumatic drug treatment, according to study results.
Researchers in London interviewed 18 patients (median age, 50 years; 14 women) with rheumatoid arthritis (RA) from an outpatient clinic. Eight patients with early RA (<2 years) received combined disease-modifying antirheumatic drugs (DMARDs), while the remainder with established RA (>2 years) received either combined DMARDs (n=5) or DMARDs and biologics (n=5).
Ten patients said they started combined therapy because their disease was not well controlled, while eight patients said monotherapy was not effective enough.
Patient feedback provided the following themes:
- Patients’ expectations about combined treatment focused mainly on improving physical symptoms (100% of patients). Seven patients said expectations were not met, causing dissatisfaction and ongoing physical discomfort.
- When rating treatment impact on quality of life, pain, swelling, stiffness, mobility and fatigue were dominant. Among the eight early RA patients, one was not satisfied, two were unsure and five were satisfied. In the established RA group, one said DMARDs and biologics did not work, three were uncertain and six were content with treatment.
- Fourteen patients expressed concerns about the combined medication and potential side effects, including ambivalence, physical problems, cancer fears, uncertainty about treatment failure and number of medications.
- Combined therapy was self-managed with close collaboration with the clinical staff. Fourteen patients had received verbal information, and 17 received written information from the staff before initiating combined therapy. Seventeen patients gave positive feedback about getting into a routine of managing combined medication on a daily basis; six patients used memory aids.
“The treatment of patients with RA is in a stage of constant flux, due to new emerging evidence about treatment modalities,” the researchers concluded. “At each stage of such treatment alterations, obtaining patients’ agreement will be imperative, as they also need to understand and ideally adapt to these changes.”