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Patient perspectives on tapering biologic or targeted synthetic therapy in well-controlled rheumatoid arthritis and comparison with providers' perspectives.
Wiemer, Nicholas; Webster, Patrick; Attur, Malavikalakshmi; Yin, Yue; Sharma, Tarun.
Afiliação
  • Wiemer N; Division of Rheumatology, Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA.
  • Webster P; Division of Rheumatology, Albert Einstein College of Medicine-Montefiore, New York, NY, USA.
  • Attur M; Drexel University College of Medicine, Philadelphia, PA, USA.
  • Yin Y; Allegheny Singer Research Institute, Allegheny Health Network, Pittsburgh, PA, USA.
  • Sharma T; Division of Rheumatology, Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA.
Rheumatology (Oxford) ; 62(Suppl_4): iv3-iv7, 2023 10 19.
Article em En | MEDLINE | ID: mdl-37855678
OBJECTIVE: We examined patient and providers' perspectives on tapering biologic or targeted synthetic disease modifying antirheumatic drugs (bDMARD or tsDMARD) in well-controlled RA to determine which factors influence their long-term treatment decisions. METHODS: A standardized phone survey was administered to patients with well-controlled RA based on electronic health record review. Providers were also surveyed. Univariate and multivariable regression analysis was performed with odds ratios (OR) and 95% CI. RESULTS: Sixty-two patients and 11 providers completed the survey. In total, 39 (63%) patients would consider a bDMARD/tsDMARD taper. Patients were more likely to consider a taper if they thought their RA was well-controlled (OR 8.02, 95% CI 2.15-29.99, P = 0.002) and of shorter duration (OR 0.94, 95% CI 0.89-0.99, P = 0.02). Patients were less likely to consider a taper if older (OR 0.95, 95% CI 0.91-1.0, P = 0.05), if they were being treated with conventional synthetic DMARDs (OR 0.25, 95% CI 0.07-0.86, P = 0.0275) or daily glucocorticoids (OR 0.08, 95% CI 0.02-0.44, P = 0.0033). Patients' and providers' top concerns about long-term bDMARD/tsDMARD use were malignancy and infection. Their concerns about tapering were worsening pain, flare and loss of function. Patients were more likely to consider a bDMARD/tsDMARD taper than providers (63% vs 36%). CONCLUSION: Patients who have had well-controlled RA are more likely to consider tapering bDMARD/tsDMARD when not being treated with csDMARDs or glucocorticoids. Patients and providers shared similar concerns regarding long-term use and tapering of bDMARD/tsDMARD, but patients were more likely to consider a taper.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artrite Reumatoide / Produtos Biológicos / Antirreumáticos Limite: Humans Idioma: En Revista: Rheumatology (Oxford) Assunto da revista: REUMATOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artrite Reumatoide / Produtos Biológicos / Antirreumáticos Limite: Humans Idioma: En Revista: Rheumatology (Oxford) Assunto da revista: REUMATOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos