Yale University School of Medicine, New Haven.
VA Connecticut Healthcare System, West Haven, Connecticut, USA.
Curr Opin Rheumatol. 2019 May;31(3):256-263. doi: 10.1097/BOR.0000000000000591.
To provide an overview of recent articles discussing patient preferences for rheumatoid arthritis (RA) treatment.
Recent studies examined patient preferences for RA treatment in several populations, finding that most participants were willing to accept certain risks of adverse effects to gain potential benefits. Perspectives regarding cannabis were studied, with patients describing medical marijuana as an alternative therapy to be used with prescription medications or as means of tapering off these medications. Treatment preferences for different RA therapies were explored using a conjoint analysis survey and five distinct preference phenotypes emerged, with members of the largest group most concerned with the cost of medications. Other discrete choice studies demonstrated route of administration as an important attribute influencing treatment preferences, with patients expressing preference for various modes in different studies. Patient preferences for route of administration have demonstrated preference for newer autoinjectors over prefilled syringes as well as currently marketed autoinjectors. Incorporating patient preferences in clinical practice recommendations was described in the development of the 2015 American College of Rheumatology (ACR) RA treatment guidelines as well as the 2017 ACR/American Association of Hip and Knee Surgeons guidelines for perioperative management of antirheumatic medications. In addition, other studies explored preferences with regard to predictive testing, medication intensification and tapering, treatment goals, and psychological support.
Our review of recent studies show variability in patient preferences for RA treatment, highlighting the importance of incorporating patient input into the treatment approach.
提供最近讨论类风湿关节炎（RA）治疗患者偏好的文章概述。
最近的研究在几个群体中研究了 RA 治疗的患者偏好，发现大多数参与者愿意接受某些不良反应风险，以获得潜在益处。研究了对大麻的看法，患者将医用大麻描述为替代疗法，可与处方药物一起使用或作为减少这些药物的手段。使用联合分析调查探讨了不同 RA 治疗方法的治疗偏好，出现了五个不同的偏好表型，最大组的成员最关注药物的成本。其他离散选择研究表明，给药途径是影响治疗偏好的重要属性，患者在不同研究中表达了对各种模式的偏好。
患者对给药途径的偏好已证明对新型自动注射器相对于预填充注射器以及当前市售自动注射器的偏好。2015 年美国风湿病学会（ACR）RA 治疗指南以及 2017 年 ACR/美国髋关节和膝关节外科医师协会关于抗风湿药物围手术期管理指南的制定中描述了将患者偏好纳入临床实践建议。此外，其他研究还探讨了预测性检测、药物强化和减药、治疗目标和心理支持方面的偏好。
我们对最近研究的综述表明，RA 治疗患者的偏好存在差异，强调将患者意见纳入治疗方法的重要性。
