Background/Purpose: Biologic agents (bDMARDs) have been shown to help control disease progression in rheumatoid arthritis (RA) and reduce joint damage. The aim of our research is to better understand patient compliance to guide the development of strategies to combat poor adherence.

Methods:  We used data collected as part of an online patient survey conducted among 500 Rheumatoid Arthritis (RA) patients in December 2015 in 5 EU countries (France, Germany, Italy, Spain, UK). We focused our research on 197 patients treated with a biologic, 111 of which missed a dose in treatment within the previous 6 months. We analysed the route of administration of their treatment to assess the influence of intravenous infusions (IV) versus subcutaneous injections (SC). We also explored whether any correlation existed between patients’ adherence to therapy and their relationship with the doctor they would normally see for their RA.

Results: 56.3% of our patients reported missing a dose of their biologic in the previous 6 months and on average these patients missed 2.8 doses during this period. Reasons cited for missing their dose include: “I felt better and didn’t think I needed it” (29%), “I felt worse and didn’t want it” (22%), “I didn’t think it was helping” (17%) and other less common reasons such as infection, other types of sickness or surgery. Patients treated with SC biologics account for 55.3% of our sample and 54.1% of these patients reported being non-compliant with treatment in the period analysed, missing on average 2.8 doses. Although we had previously hypothesized that adherence may be higher among patients receiving an IV biologic, 58.0% of IV patients reported being non-compliant with treatment with a mean of 2.7 missed doses. Interestingly 38% of IV patients cited feeling better and thinking they did not need treatment, whereas 20% of SC patients reported feeling worse and not wanting to take their injection treatment. We then looked at assessing whether the route of administration had an effect on patient’s compliance to treatment using Pearson correlation analysis however, our findings deduced no significant relationship between both data sets. Further analysis looked at whether the relationship with the primary health care professional (HCP) had any possible influence on the outcome of compliance, however once again a Pearson correlation analysis found no significant link when non-compliant patients scored their relationship based on specific statements describing their relationship with the doctor they normally see for their RA.

Conclusion: Our research shows that a significant proportion of biologic patients miss one or more doses of their prescribed biologic over a 6 month period despite the benefits and cost of these therapies. Additional research is needed to optimise patient engagement with their disease and the healthcare providers they interact with to ensure improved long-term compliance with therapy.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/patient-adherence-with-biologic-therapy-in-rheumatoid-arthritis-a-real-world-review-of-compliance/