Adelphi Real World, Bollington, UK.
Global Health Economics and Outcomes Research, Teva Pharmaceutical Industries Ltd., Frazer, PA, USA.
Adv Ther. 2020 Sep;37(9):3985-3999. doi: 10.1007/s12325-020-01445-4. Epub 2020 Jul 29.
To evaluate, from the patient's perspective, the burden of pain associated with hip/knee osteoarthritis (OA) in the USA and selected European Union (EU) countries.
Data were drawn from the 2017 global Adelphi OA Disease Specific Programme™ (DSP). Patients with hip/knee OA were stratified based on pain intensity and the presence/absence of current opioid use. Outcomes included Western Ontario and McMaster Universities Osteoarthritis Index scores, functional limitations, unmet treatment needs, Charlson Comorbidity Index, relevant comorbid conditions, the 5-dimension 5-level EuroQol, and the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem. Bivariate testing compared outcomes using patients with no/mild pain without opioid use as the reference group.
The study population comprised 2170 patients (US: n = 623 [28.7%]; EU: n = 1547 [71.3%]) with knee (54.9%), hip (24.6%), or knee/hip (20.5%) OA. Mean (SD) age was 66.4 (11.2) years. Patients had no/mild pain without opioid use (39.6%), no/mild pain with opioid use (10.2%), moderate/severe pain without opioid use (30.6%), and moderate/severe pain with opioid use (19.7%). Compared with the reference group, patients with moderate/severe pain reported significantly (p < 0.05) higher functional limitations, greater use of ≥ 3 treatments and treatment dissatisfaction, reduced quality of life, and impaired work productivity and activity. The burden was highest with moderate/severe pain with opioid use. Results were generally similar in the US and EU cohorts.
The results from this multinational cross-sectional study indicate that the impact of OA pain is multidimensional, worsened by increasing pain intensity, and may not be adequately addressed by current treatment strategies.
本研究旨在从患者角度评估美国和部分欧盟国家髋/膝关节骨关节炎(OA)相关疼痛的负担。
数据来自 2017 年全球 Adelphi OA 疾病专项研究项目(DSP)。根据疼痛强度和当前是否使用阿片类药物对髋/膝关节 OA 患者进行分层。评估指标包括西部安大略省和麦克马斯特大学骨关节炎指数评分、功能受限、未满足的治疗需求、Charlson 共病指数、相关合并症、五维五度欧洲生活质量量表(EQ-5D-5L)和工作生产力和活动障碍问卷:特异性健康问题(WPAI:SHP)。采用双变量检验比较无/轻度疼痛且未使用阿片类药物的患者作为参考组的结果。
研究人群包括 2170 例患者(美国:n=623 [28.7%];欧盟:n=1547 [71.3%]),分别患有膝关节(54.9%)、髋关节(24.6%)或膝关节/髋关节(20.5%)OA。平均(SD)年龄为 66.4(11.2)岁。患者中无/轻度疼痛且未使用阿片类药物者(39.6%)、无/轻度疼痛且使用阿片类药物者(10.2%)、中重度疼痛且未使用阿片类药物者(30.6%)和中重度疼痛且使用阿片类药物者(19.7%)。与参考组相比,中重度疼痛患者报告功能受限更严重、使用≥3 种治疗药物和治疗满意度降低、生活质量下降、工作生产力和活动受损的情况更严重。中重度疼痛且使用阿片类药物者的负担最高。美国和欧盟队列的结果基本相似。
本跨国横断面研究结果表明,OA 疼痛的影响是多维度的,疼痛强度增加会使疼痛恶化,且目前的治疗策略可能无法充分解决这一问题。