Adherence to Anti-Tumor Necrosis Factor Therapy Administered Subcutaneously and Associated Factors in Patients With Rheumatoid Arthritis.

Abstract

BACKGROUND:

Adherence to biologic therapy is relatively poorly studied in rheumatoid arthritis (RA) because many of the studies have investigated the drug persistence, which represents only a surrogate of adherence.

OBJECTIVES:

The aims of this study were to determine the extent of adherence in RA patients with subcutaneously administered anti-tumor necrosis factor methotrexate agents and to identify the risk factors for nonadherence.

METHODS:

A cohort of RA patients who started a subcutaneous anti-tumor necrosis factor treatment were enrolled. After 12 months of treatment, all patients completed the 4-item Morisky Medication Adherence Scale questionnaire. Associations between beliefs and nonadherence and the influence of demographic, clinical, and radiographic features were assessed using logistic regression model.

RESULTS:

A total of 209 (80.4%) of the 260 patients were included in the analyses. Forty-three of 209 patients were considered nonadherent to their medication (20.6%) according to the 4-item Morisky Medication Adherence Scale. More than half (53.1%) of patients showed at least 1 form of nonadherent behavior.The logistic model showed that low disease activity (P = 0.003), higher patient-physician discordance ratings (P = 0.012), older age (P = 0.041), and a high number of comorbid conditions (P = 0.011) were significantly associated with increased likelihood of nonadherence.

CONCLUSIONS:

The overall nonadherence with subcutaneous biologic therapy is relatively high among RA patients and should be taken into account when a patient's response to treatment is unsatisfactory.

• Authors: Fausto Salaffi, Marina Carotti, Marco Di Carlo, Sonia Farah, Marwin Gutierrez
• Journal: Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases (J Clin Rheumatol) Vol. 21 Issue 8 Pg. 419-25 (Dec 2015) ISSN: 1536-7355 [Electronic] United States
• PMID: 26587852 (Publication Type: Journal Article)

Chemical References

• Antirheumatic Agents
• Tumor Necrosis Factor-alpha

Topics

• Age Factors
• Aged
• Antirheumatic Agents (administration & dosage, adverse effects)
• Arthritis, Rheumatoid (diagnosis, drug therapy, metabolism)
• Biological Therapy (methods, psychology, statistics & numerical data)
• Comorbidity
• Female
• Humans
• Injections, Subcutaneous
• Male
• Medication Adherence (statistics & numerical data)
• Middle Aged
• Patient Acuity
• Physician-Patient Relations
• Surveys and Questionnaires
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)