Abstract
For the optimum efficacy of disease-modifying anti-rheumatic drugs (DMARDs), patients need to be adherent to their medication regimen. To clarify the effects of medication adherence on disease activity in Japanese patients with rheumatoid arthritis (RA), we conducted a cohort study in patients with various stages of RA. Patients were enrolled from the Kyoto University RA Management Alliance cohort, and followed up prospectively for 12 months. In this study, a total of 475 patients were analyzed and divided into 9 groups according to their medication adherence and the RA disease duration. The primary outcomes were based on the rate of a disease flare. The secondary outcomes were the changes in disease activity score using 28 joints (DAS28-ESR), simplified disease activity index (SDAI) and physical disability by health assessment questionnaire-disability index (HAQ). The changes in DAS28-ESR, HAQ, and the risk of disease flare in the highly adherent patients were significantly lower than those of the less adherent patients among the groups with RA ≤ 4.6 years but not those among the other groups. Taken together, this study identified a significant association between medication adherence and the disease flare during early-stage RA or short disease duration. These results emphasize the need to pay more attention to medication adherence in preventing the disease progression of RA.
Highlights
Rheumatoid arthritis (RA) is a chronic inflammatory disease that can result in severe disability and morbidity
One has indicated that medication adherence is associated with improvements in disease activity and physical functional outcomes among disease-modifying anti-rheumatic drugs (DMARDs)-naïve patients, but not among existing users [13]
The results showed that medication adherence was significantly related to the decreased risk of disease flare among the patients using MTX and bioDMARDs
Summary
Rheumatoid arthritis (RA) is a chronic inflammatory disease that can result in severe disability and morbidity. Several studies have demonstrated an association between higher medication adherence and better clinical response to therapies in RA patients [8,9,10,11,12,13] Of these investigations, one has indicated that medication adherence is associated with improvements in disease activity and physical functional outcomes among DMARDs-naïve patients, but not among existing users [13]. One has indicated that medication adherence is associated with improvements in disease activity and physical functional outcomes among DMARDs-naïve patients, but not among existing users [13] These findings suggest that medication adherence is a significant factor in treatment of early-stage RA. We conducted a cohort study in patients with various stages of RA
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