Impact of Adherence to Golimumab on Disease Flares in Rheumatoid Arthritis: Results from a Canadian Observational Study.

IF 2 3区医学 Q2 MEDICINE, GENERAL & INTERNAL

Patient preference and adherence Pub Date : 2025-06-25 eCollection Date: 2025-01-01 DOI:10.2147/PPA.S516794

Louis Bessette, Pauline Boulos, Regan Arendse, Proton Rahman, Sam Aseer, Thanu Ruban, Meagan Rachich, Francois Nantel, Adriana Calce, Odalis Asin-Milan, Derek Haaland

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Abstract

Objective: To assess the association between adherence to golimumab treatment and the incidence of disease flares in patients with rheumatoid arthritis (RA) in routine clinical practice.

Methods: A 12-month (M) prospective observational study conducted across 27 Canadian centers, involving patients with RA receiving golimumab as part of routine clinical care. Treatment adherence was assessed with the Compliance Questionnaire in Rheumatology (CQR); non-adherence was defined as a weighted baseline score predictive of ≤80% compliance. Secondary definitions involved the CQR score at M6 and M12. Disease flaring was assessed with the RA-Flare Questionnaire (RA-FQ); flare was defined as a positive response to question 7 ("Are you having a flare?"). The association between adherence and disease flares was analyzed by comparing RA-FQ scores and the proportion of patients reporting flares between the high and low adherence groups. The association between adherence and glucocorticoid use or adverse event (AE) incidence was similarly assessed.

Results: Of 215 patients enrolled, 169 (78.6%) completed the study. No significant difference in mean RA-FQ scores was observed between low and high adherence groups at M6 (22.5 vs 23.8; p=0.56) and M12 (20.8 vs 19.9; p=0.70); disease flares were reported by 35.7% of low adherence patients, compared to 28.2% in the high adherence group (p=0.34). At M12, these rates were 30% vs 24.7%, respectively (p=0.49). Glucocorticoid use was comparable between baseline adherence groups, although a higher rate was observed in the low visit-predicted adherence group based on the M6 CQR score (30.5% vs 16.3%; p=0.04). No significant differences were observed in AE incidence.

Conclusion: In this study, no significant differences in RA-FQ scores and the proportions of patients reporting disease flares or AEs were observed between patients with RA with low and high predicted adherence to golimumab. The increased glucocorticoid use in patients with low adherence merits further investigation.

Trial registration: ClinicalTrials.gov identifier, NCT03729349.

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依从戈利姆单抗对类风湿关节炎疾病发作的影响：来自加拿大观察性研究的结果

目的：评估在常规临床实践中，类风湿关节炎（RA）患者坚持戈利姆单抗治疗与疾病发作发生率之间的关系。方法：在加拿大27个中心进行了一项为期12个月的前瞻性观察性研究，包括接受golimumab作为常规临床护理一部分的RA患者。采用风湿病依从性问卷（CQR）评估治疗依从性；不依从性定义为加权基线评分，预测依从性≤80%。二级定义包括CQR评分在M6和M12。采用RA-Flare问卷（RA-FQ）评估疾病爆发；耀斑被定义为对问题7（“你有耀斑吗？”）的积极回应。通过比较高依从性组和低依从性组的RA-FQ评分和报告发作的患者比例，分析依从性与疾病发作之间的关系。同样评估了依从性与糖皮质激素使用或不良事件（AE）发生率之间的关系。结果：在215例入组患者中，169例（78.6%）完成了研究。低依从性组和高依从性组在M6时的平均RA-FQ评分无显著差异(22.5 vs 23.8；p=0.56)和M12 (20.8 vs 19.9；p = 0.70);35.7%的低依从性患者报告了疾病发作，而高依从性组为28.2% （p=0.34）。在M12时，这些比率分别为30%和24.7% （p=0.49）。糖皮质激素的使用在基线依从性组之间具有可比性，尽管基于M6 CQR评分的低就诊预测依从性组观察到更高的比率(30.5% vs 16.3%；p = 0.04)。两组AE发生率无显著差异。结论：在这项研究中，预测低依从性和高依从性的RA患者在RA- fq评分和报告疾病发作或ae的患者比例上没有显著差异。低依从性患者糖皮质激素使用的增加值得进一步研究。试验注册：ClinicalTrials.gov识别码，NCT03729349。

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来源期刊

Patient preference and adherence MEDICINE, GENERAL & INTERNAL-

CiteScore

3.60

自引率

4.50%

发文量

354

审稿时长

6-12 weeks

期刊介绍： Patient Preference and Adherence is an international, peer reviewed, open access journal that focuses on the growing importance of patient preference and adherence throughout the therapeutic continuum. The journal is characterized by the rapid reporting of reviews, original research, modeling and clinical studies across all therapeutic areas. Patient satisfaction, acceptability, quality of life, compliance, persistence and their role in developing new therapeutic modalities and compounds to optimize clinical outcomes for existing disease states are major areas of interest for the journal. As of 1st April 2019, Patient Preference and Adherence will no longer consider meta-analyses for publication.