Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Multi-Centre, Observational Study Shows High Proportion of Australian Rheumatoid Arthritis Patients Have Inadequate Disease Control.
Littlejohn2, Geoffrey, Tymms1, Kathleen E.
Contemporary management of rheumatoid arthritis [RA] includes early use of disease modifying drugs with the aim to achieve disease remission. RA management in Australia involves drug algorithms based on disease activity predefined by health care payers. This study used a new methodology in order to evaluate the disease activity and current therapy of RA patients managed in Australia.
Using a point of care electronic clinical management program, details of RA patients treated in 21 participating Australian clinics were collected at one point in time. This included patient demographics, diagnosis, medications and disease measures. The data was de-identified to patient, clinic and clinician. Analysis of this data was conducted to determine the proportion of RA patients who were in disease remission (DAS28 <2.6), low disease activity (LDA, DAS28 2.63.1), moderate disease activity (MDA, DAS28 3.25.1) and high disease activity (HDA, DAS28 >5.1), and their respective treatments. Ethics approval was granted by the University of New South Wales Human Research Ethics Committee.
As of the 23rd April 2010, 4766 rheumatoid arthritis patients (73% females; 26% males, <1% gender indeterminate) had been assessed at 21 participating clinics. The mean age was 61.5 (60.5 females, 64.2 males) and mean disease duration was 12.6 years (13.1 females, 11.3 males). DAS28 scores were recorded for 51% of patients with 42% in remission, 20% in LDA, 30% in MDA and 8% in HDA. Of the patients in remission, 20% were being treated with a bDMARD, 77% with methotrexate (MTX), 24% with leflunomide (LEF), and 36% with prednisone. Of the patients in MDA, 23% were being treated with a bDMARD, 80% with MTX, 33% with LEF and 49% with prednisone. Of the patients in HDA, 30% were being treated with a bDMARD, 84% with MTX, 45% with LEF and 65% with prednisone.
Overall, 18% of patients were being treated with a bDMARD and 35% of patients were being treated with prednisone.
Cross-sectional assessment of this large cohort of Australian RA patients, managed in accordance with contemporary practice, shows a large number who have moderate and high disease activity. As disease activity predicts radiological and functional outcomes, this indicates that current RA management practice in Australia will result in significant future health burden in RA patients.
To cite this abstract, please use the following information:
Littlejohn, Geoffrey, Tymms, Kathleen E.; Multi-Centre, Observational Study Shows High Proportion of Australian Rheumatoid Arthritis Patients Have Inadequate Disease Control. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :320