Sun Jiaying, Dai Siming, Zhang Ling, Feng Yajing, Yu Xin, Zhang Zhiyi
Department of Rheumatology and Immunology, First Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang, China.
Shanghai Roche Pharmaceuticals Ltd., Shanghai, 201203, China.
Clin Rheumatol. 2021 May;40(5):1789-1798. doi: 10.1007/s10067-020-05458-w. Epub 2020 Oct 15.
Rheumatoid arthritis (RA) significantly impacts the health of Chinese patients. Conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) are used as the standard treatment for patients with RA. However, Chinese patients with RA have reported poor compliance with csDMARDs. This study aims to better understand the safety and compliance of using csDMARDs in RA treatment. Face-to-face interviews were conducted by questionnaires on safety and compliance of csDMARDs in 400 patients with RA and 100 rheumatologists from 13 cities in China. Rheumatologists were from Tier 3 Class A hospitals with independent rheumatology departments, who admitted more than 30 patients with RA per week. All patients were diagnosed for > 3 months before the survey and had been treated with csDMARDs for > 3 months. The incidence of adverse events (AEs) that attributed to csDMARDs estimated by rheumatologists was lower than that reported by patients for all four prescribed csDMARDs. Also, types of common AEs in rheumatologist's perception differed from those in the patient's report. Only 86% (116/135) of patients claimed they notified their rheumatologist about AEs, and 40.8% (150/368) of patients did not strictly adhere to their prescribed treatment. Reasons why patients were not compliant with their treatment, other than AEs, included symptoms being less severe, travel, and busy working life/business trips. This study revealed gaps in perceptions of csDMARDs-related AEs and medication adherence between rheumatologists and patients. These findings suggested adequate doctor-patient communications, and considerations of multiple real-world situations may improve adherence in the treatment of RA patients. Key Points • This study identified gaps in rheumatologists' perception of the prevalence and type of AEs experienced by their patients, which could potentially help them improve their patients' compliance with treatment.
类风湿关节炎（RA）对中国患者的健康有显著影响。传统合成改善病情抗风湿药（csDMARDs）被用作RA患者的标准治疗药物。然而，中国的RA患者报告称对csDMARDs的依从性较差。本研究旨在更好地了解使用csDMARDs治疗RA时的安全性和依从性。通过问卷调查对来自中国13个城市的400例RA患者和100名风湿病学家进行了面对面访谈，内容涉及csDMARDs的安全性和依从性。风湿病学家来自具有独立风湿科的三级甲等医院，每周收治30多名RA患者。所有患者在调查前已确诊超过3个月，且接受csDMARDs治疗超过3个月。风湿病学家估计的由csDMARDs引起的不良事件（AE）发生率低于患者报告的所有四种规定csDMARDs的不良事件发生率。此外，风湿病学家认知中的常见AE类型与患者报告的不同。只有86%（116/135） 的患者声称他们向风湿病学家通报了AE，40.8%（150/368）的患者没有严格遵守规定的治疗。除AE外，患者不遵守治疗的原因包括症状不太严重、旅行以及工作繁忙/出差。本研究揭示了风湿病学家和患者在csDMARDs相关AE认知和药物依从性方面的差距。这些发现表明，充分的医患沟通以及考虑多种现实情况可能会提高RA患者治疗的依从性。要点 • 本研究发现了风湿病学家对患者经历的AE患病率和类型认知上的差距，这可能有助于他们提高患者的治疗依从性。
