A multi‐center, observational study shows high proportion of Australian rheumatoid arthritis patients have inadequate disease control
Identifieur interne : 001261 ( Main/Exploration ); précédent : 001260; suivant : 001262A multi‐center, observational study shows high proportion of Australian rheumatoid arthritis patients have inadequate disease control
Auteurs : Geoffrey Littlejohn [Australie, États-Unis] ; Lynden Roberts [Australie] ; Mark Arnold [Australie] ; Paul Bird [Australie] ; Simon Burnet [Australie] ; Julien De Jager [Australie] ; Hedley Griffiths [Australie] ; Dave Nicholls [Australie] ; James Scott [Australie] ; Jane Zochling [Australie] ; Kathleen E. Tymms [Australie]Source :
- International Journal of Rheumatic Diseases [ 1756-1841 ] ; 2013-10.
English descriptors
- Teeft :
- American college, Arthritis, Arthritis rheum, Asia league, Audit4 point, Audit4 software, Australian landscape, Bdmard, Care software, Clinical characteristics, Clinical practice, Clinician, Disease activity, Disease activity group, Disease activity index, Disease activity score, Disease activity state, Disease activity states, Disease control, Disease duration, Disease measures, Disease remission, Disease states, Disease status, Elbow involvement, Erythrocyte sedimentation rate, Gender unassigned, High disease activity, High proportion, Inadequate disease control, Individual clinicians, Initiation dates, International journal, Joint damage, Joint involvement, Joints erythrocyte sedimentation rate, Large cohort, Large proportion, Medical record, Medication, Moderate disease activity, Monash university, Observational study, Opal, Opal consortium, Other conditions, Patient demographics, Patient population, Pharmacological interventions, Prednisolone, Protocol development, Remission, Remission group, Remission study, Rheum, Rheumatic diseases, Rheumatoid, Rheumatoid arthritis, Rheumatoid arthritis patients, Rheumatologist, Rheumatology, Rheumatology practices, Roche products, Software, Study design, Treatment options.
Abstract
Objectives: To evaluate the disease activity and current pharmacological interventions used to achieve remission in rheumatoid arthritis (RA) patients in Australia. Methods: Rheumatoid arthritis patients treated in participating Australian clinics were included in the study. Patient demographics, disease onset, medications and disease measures were analyzed. Data, de‐identified to the patient, clinic and clinician were captured using an electronic clinical management program. The disease activity score (DAS28) was used to classify patients into the disease activity states of remission, low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA). Choice of therapy was at the discretion of the treating clinician. Results: A total of 5686 patients, 72.9% female, 26.9% male, with mean age 61.1 (SD 13.6) years and mean disease duration of 11.5 (SD 10.5) years were analyzed. DAS28 ESR (erythrocyte sedimentation rate) scores were recorded for 2973 patients, with 41.6% in remission, 18.6% LDA, 31.6% MDA and 8.2% HDA. Of those in remission, 17% received a biological disease modifying anti‐rheumatic drug (bDMARD), 73% methotrexate (MTX), 19% leflunomide (LEF) and 28% prednisolone. Of the patients with MDA, 20% received a bDMARD, 76% MTX, 24% LEF and 39% prednisolone. Of the patients in HDA, 27% received a bDMARD, 78% MTX, 31% LEF and 60% with prednisolone. Conclusions: Cross‐sectional assessment of this large cohort of Australian RA patients found a large proportion remain in moderate or high disease activity; suggesting a considerable evidence–practice gap. Improvement in disease control in this group may reduce future health burdens.
Url:
DOI: 10.1111/1756-185X.12163
Affiliations:
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Methods: Rheumatoid arthritis patients treated in participating Australian clinics were included in the study. Patient demographics, disease onset, medications and disease measures were analyzed. Data, de‐identified to the patient, clinic and clinician were captured using an electronic clinical management program. The disease activity score (DAS28) was used to classify patients into the disease activity states of remission, low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA). Choice of therapy was at the discretion of the treating clinician. Results: A total of 5686 patients, 72.9% female, 26.9% male, with mean age 61.1 (SD 13.6) years and mean disease duration of 11.5 (SD 10.5) years were analyzed. DAS28 ESR (erythrocyte sedimentation rate) scores were recorded for 2973 patients, with 41.6% in remission, 18.6% LDA, 31.6% MDA and 8.2% HDA. Of those in remission, 17% received a biological disease modifying anti‐rheumatic drug (bDMARD), 73% methotrexate (MTX), 19% leflunomide (LEF) and 28% prednisolone. Of the patients with MDA, 20% received a bDMARD, 76% MTX, 24% LEF and 39% prednisolone. Of the patients in HDA, 27% received a bDMARD, 78% MTX, 31% LEF and 60% with prednisolone. Conclusions: Cross‐sectional assessment of this large cohort of Australian RA patients found a large proportion remain in moderate or high disease activity; suggesting a considerable evidence–practice gap. Improvement in disease control in this group may reduce future health burdens.</div></front></TEI><affiliations><list><country><li>Australie</li><li>États-Unis</li></country><region><li>Nouvelle-Galles du Sud</li></region><settlement><li>Sydney</li></settlement></list><tree><country name="Australie"><noRegion><name sortKey="Littlejohn, Geoffrey" sort="Littlejohn, Geoffrey" uniqKey="Littlejohn G" first="Geoffrey" last="Littlejohn">Geoffrey Littlejohn</name></noRegion><name sortKey="Arnold, Mark" sort="Arnold, Mark" uniqKey="Arnold M" first="Mark" last="Arnold">Mark Arnold</name><name sortKey="Bird, Paul" sort="Bird, Paul" uniqKey="Bird P" first="Paul" last="Bird">Paul Bird</name><name sortKey="Burnet, Simon" sort="Burnet, Simon" uniqKey="Burnet S" first="Simon" last="Burnet">Simon Burnet</name><name sortKey="De Jager, Julien" sort="De Jager, Julien" uniqKey="De Jager J" first="Julien" last="De Jager">Julien De Jager</name><name sortKey="Griffiths, Hedley" sort="Griffiths, Hedley" uniqKey="Griffiths H" first="Hedley" last="Griffiths">Hedley Griffiths</name><name sortKey="Nicholls, Dave" sort="Nicholls, Dave" uniqKey="Nicholls D" first="Dave" last="Nicholls">Dave Nicholls</name><name sortKey="Roberts, Lynden" sort="Roberts, Lynden" uniqKey="Roberts L" first="Lynden" last="Roberts">Lynden Roberts</name><name sortKey="Scott, James" sort="Scott, James" uniqKey="Scott J" first="James" last="Scott">James Scott</name><name sortKey="Tymms, Kathleen E" sort="Tymms, Kathleen E" uniqKey="Tymms K" first="Kathleen E." last="Tymms">Kathleen E. Tymms</name><name sortKey="Zochling, Jane" sort="Zochling, Jane" uniqKey="Zochling J" first="Jane" last="Zochling">Jane Zochling</name></country><country name="États-Unis"><noRegion><name sortKey="Littlejohn, Geoffrey" sort="Littlejohn, Geoffrey" uniqKey="Littlejohn G" first="Geoffrey" last="Littlejohn">Geoffrey Littlejohn</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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