Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, Milano, Italy.
RMD Open. 2021 Jun;7(2). doi: 10.1136/rmdopen-2021-001637.
Early diagnosis and treatment of rheumatoid arthritis (RA) are of critical importance to halt the progression of the disease. Optimal use of advanced imaging techniques or biomarkers may facilitate early diagnosis of RA. Even though many disease-modifying anti-rheumatic drugs (DMARDs) are available for RA treatment, biological DMARDs (bDMARDs) offer expanding therapeutic options and good outcomes in patients with RA who do not have a sufficient response to conventional synthetic DMARDs. However, high costs of bDMARDs have limited patient access to optimised disease management and increased the cost burden for healthcare systems. The advent of biosimilars led to significant cost savings driven by price competition among the reference products, which could be beneficial for healthcare systems. Healthcare provider (HCP)-patient communication and informed shared decision-making are crucial to prevent the occurrence of a nocebo effect, which results from negative perceptions that patients may have and could lead to less effective outcomes. Research has demonstrated that effective communication between HCPs and patients utilising positive framing can improve acceptance by patients to be initiated on or switched to a biosimilar and can help to integrate biosimilars into routine clinical practice to maximise benefits for patients with RA.
类风湿关节炎（RA）的早期诊断和治疗对阻止疾病进展至关重要。优化使用先进的影像学技术或生物标志物可能有助于早期诊断 RA。尽管有许多治疗类风湿关节炎的疾病修饰抗风湿药物（DMARDs），但生物 DMARDs（bDMARDs）为对传统合成 DMARDs 反应不足的 RA 患者提供了更多的治疗选择和良好的疗效。然而，bDMARDs 的高成本限制了患者获得优化疾病管理的机会，并增加了医疗保健系统的成本负担。生物类似药的出现带来了显著的成本节约，这是由于参考产品之间的价格竞争所致，这对医疗保健系统可能是有益的。医疗保健提供者（HCP）与患者之间的沟通和知情的共同决策对于预防出现源自于患者负面看法的“反安慰剂效应”至关重要，这可能导致治疗效果不佳。研究表明，HCP 与患者之间使用积极框架的有效沟通可以提高患者对生物类似药的接受度，使其开始使用或转换为生物类似药，并有助于将生物类似药纳入常规临床实践，从而使 RA 患者最大程度受益。
