Background Disease remission is a key target while managing patients with Rheumatoid Arthritis (RA).
Objectives To assess the patterns of disease remission among RA patients recently treated with biologic therapies in Japan.
Methods A multi-center medical chart-review study of RA patients was conducted among physicians (rheumatologists) in hospitals/private practices to collect de-identified data on patients who were currently on a biologic or recently discontinued a biologic within past 3-months. Physicians were screened for practice-duration and patient-volume and recruited from a large panel to be geographically representative of Japan. Patient charts of ∼10 successive patients visiting each center/practice during study period were selected. Physicians abstracted patient diagnosis, treatment patterns/dynamics and patient symptomatology/disease status (incl. assessment of “disease remission”, per physician clinical judgment (both objective & subjective)).
Results In 4Q2011, physicians abstracted 435 eligible RA patient charts; 79%, 17%and 3% were on 1st line, 2nd line and 3rd line biologic respectively. Overall, 49% of patients were in remission; the mean duration of remission status was 16.7 months. Remission-rate differed by biologic lines: 1st-line:53%, 2nd-line:41%, 3rd-line:21%. Among those with lab measures, results differed between those in remission vs. those who were not: mean ESR (mm/h): 18.1 vs. 30.6, mean CRP (mg/dl): 0.5 vs. 1.2, mean MMP3 (ng/ml): 84.7-vs-136.7, Rheumatoid Factor (% positive): 87%>vs-91% and Anti-CCP (% positive): 91%>vs-94%. Among those with available data, recent (mean) disease severity scores differed between those in remission vs. those who were not: Tender Joint Count: 0.8-vs-2.7, Swollen Joint Count: 0.8-vs-2.6, 100mm VAS score: 12.8-vs-32.2, HAQ: 0.1-vs-0.2 and DAS28: 1.8-vs-3.7.
Conclusions Approximately half of the patients were not in remission in this cohort of RA patients in Japan who were treated with a biologic; they experienced disproportionate level of disease burden. As the line of treatment increased, proportion of individuals achieving remission decreased. These observed patterns warrant further scrutiny to determine the best practices and improve remission rates, thereby alleviating patient burden.
Disclosure of Interest S. Narayanan Employee of: Ipsos, Y. Lu Employee of: Ipsos, R. Hutchings Employee of: Ipsos, A. Baskett Employee of: Ipsos