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Does practice mirror the evidence base in the treatment of rheumatoid arthritis?

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Abstract

A large base of evidence exists regarding treatments for rheumatoid arthritis (RA) and how they may be used to preserve long-term function and improve patient outcomes. However, little is known about whether real-life rheumatology practice reflects the evidence base. This survey aimed to capture differing perceptions among rheumatologists in the identification and treatment of patients and to understand how their management of and treatment decisions for patients with RA may be influenced by the current published literature. Rheumatologists from five European countries and Canada participated in a survey between April and May 2006 to establish how rheumatologists identify and treat particular patient types in everyday practice. In total, 458 rheumatologists responded to the online and telephone survey. Rapidly progressing disease was overwhelmingly recognized (97%) as a distinct subtype among patients with RA, and the majority (88%) of respondents make treatment decisions based on this distinction. Most rheumatologists use measures including C-reactive protein, erythrocyte sedimentation rate, tender/swollen joint counts, and X-ray progression to diagnose and monitor this particular group of patients; a minority (30%) used magnetic resonance imaging to identify and monitor patients with rapidly progressing disease. Although treatment goals for these patients were similar among rheumatologists, the treatment approach varied considerably across countries. Overall, rheumatologists agree on the management goals for patients with rapidly progressing RA; however, their treatment patterns have some dissimilarities.

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Acknowledgement

The survey was executed, and responses were analyzed by Harris Interactive, an international market research company.

Funding

Financial support for this study was provided by Schering-Plough Corporation.

Disclosure

Prof. McInnes has received grant funding and honoraria from Schering-Plough, Wyeth, Abbott, and Roche, all of whom manufacture/sell biologic agents.

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Authors and Affiliations

  1. Experimental Medicine, Centre for Rheumatic Diseases, University of Glasgow, Scotland, UK

    Iain McInnes

  2. Centre for Rheumatic Diseases, University of Glasgow, Glasgow Royal Infirmary, 10 Alexandra Parade, Glasgow, G31 2ER, UK

    Iain McInnes

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  1. Iain McInnes
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Correspondence to Iain McInnes.

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McInnes, I. Does practice mirror the evidence base in the treatment of rheumatoid arthritis?. Clin Rheumatol 28, 961–970 (2009). https://doi.org/10.1007/s10067-009-1189-9

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  • DOI: https://doi.org/10.1007/s10067-009-1189-9

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