How Russian patients with rheumatoid arthritis assess their condition: initial data from the OPTIMA (Patient Assessment of Severity, Outcomes and Medical Care in Arthritis) pilot study

Abstract

Dynamic monitoring of the patient's condition is a fundamental element of the modern strategy for the treatment of rheumatoid arthritis (RA), which aims to achieve remission or low inflammatory activity of the disease. A simple and informative indicator that can be used to assess treatment outcomes from a patient's perspective is the Patient Acceptable State Status (PASS).Objective: to determine the severity of patient-reported outcomes (PROs) and their relationship to the PASS indicator in patients with RA in reallife clinical practice.Material and methods. A one-time survey of 945 patients with RA was conducted in paper and electronic form from January to June 2023. The survey included the determination of PROs (pain, fatigue, anxiety, depression, activities of daily living, global assessment of health – GAH, – global assessment of disease activity – GADA) and PASS. The majority of patients were women – 87.8%, mean age – 46.3±13.2 years, median disease duration – 6 [3; 14] years. 80.4% of patients received synthetic disease modifying antirheumatic drugs, 23.9% – biologic disease modifying antirheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKi), 36.5% – glucocorticoids (GC), 82.8% – nonsteroidal anti-inflammatory drugs (NSAIDs).Results and discussion. According to the survey, the severity of joint pain (according to a numerical rating scale, NRS 0–10) was on average 5.3±2.6, fatigue – 6.2±2.6, GAH – 5.4±2.4, GADA – 5.4±2.7, median anxiety – 5 [3; 8], depression – 5 [2; 7], limitation of daily activity – 5 [3; 7]. Satisfaction with their health condition (PASS+) reported 54.8% of patients, dissatisfaction (PASS-) was associated with the presence of moderate/severe pain (NRS ≥4; odds ratio, OR 2.665; 95% confidence interval, CI 2.072–3.429; p<0.001), fatigue (OR 2.497; 95% CI 1.818–3.430; p><0.001), anxiety (OR 1.683; 95% CI 1.395–2.029; p><0.001) and depression (OR 1.537; 95% CI 1.308–1.805; p><0.001). PASS- was statistically significant more common in patients taking NSAIDs and GCs and significantly less common in patients receiving bDMARDs and JAKi. Conclusion. PASS is associated with the main PROs (pain, fatigue, anxiety and depression) and can be used as one of the indicators for evaluating the effectiveness of RA treatment. Keywords: rheumatoid arthritis; Patient Acceptable State Status; patient-reported outcomes; pain; fatigue; depression; anxiety> ˂ 0.001), fatigue (OR 2.497; 95% CI 1.818–3.430; p<0.001), anxiety (OR 1.683; 95% CI 1.395–2.029; p><0.001) and depression (OR 1.537; 95% CI 1.308–1.805; p><0.001). PASS- was statistically significant more common in patients taking NSAIDs and GCs and significantly less common in patients receiving bDMARDs and JAKi. Conclusion. PASS is associated with the main PROs (pain, fatigue, anxiety and depression) and can be used as one of the indicators for evaluating the effectiveness of RA treatment. Keywords: rheumatoid arthritis; Patient Acceptable State Status; patient-reported outcomes; pain; fatigue; depression; anxiety> ˂ 0.001), anxiety (OR 1.683; 95% CI 1.395–2.029; p<0.001) and depression (OR 1.537; 95% CI 1.308–1.805; p><0.001). PASS- was statistically significant more common in patients taking NSAIDs and GCs and significantly less common in patients receiving bDMARDs and JAKi. Conclusion. PASS is associated with the main PROs (pain, fatigue, anxiety and depression) and can be used as one of the indicators for evaluating the effectiveness of RA treatment. Keywords: rheumatoid arthritis; Patient Acceptable State Status; patient-reported outcomes; pain; fatigue; depression; anxiety> ˂ 0.001). PASS- was statistically significant more common in patients taking NSAIDs and GCs and significantly less common in patients receiving bDMARDs and JAKi.Conclusion. PASS is associated with the main PROs (pain, fatigue, anxiety and depression) and can be used as one of the indicators for evaluating the effectiveness of RA treatment.

Keywords

• rheumatoid arthritis
• patient acceptable state status
• patient-reported outcomes
• pain
• fatigue
• depression
• anxiety