Background/Purpose: Our hypothesis is that patients have a positive opinion regarding the newer, biologic DMARDs and a negative sentiment towards the conventional synthetic agents. We sought to analyse discussions on social media platforms regarding DMARDs so understand the collective sentiment expressed towards these medications. 

Methods: Treato data analytics were utilised to download all available discussions on social media about DMARDs in the context of Rheumatoid arthritis. Strict filters were used to ensure that only user (patient) generated content was downloaded. The sentiment (positive or negative) expressed in these posts was analysed for each DMARD using the Natural Language Processing technique of Sentiment Analysis. We then further analysed the reason for this sentiment for each DMARD, looking specifically at the categories of efficacy and side effects.

Results: Sophisticated computer generated algorithms analysed hundreds of millions of posts and finally included 54,742 social media discussion about csDMARDs and bDMARDs. The overall ratio of positive comments to negative comments was higher for bDMARDs (1.296) than for csDMARDs (1.079). Tofacitinib had the highest ratio of positive to negative comments (1.71) whereas sulfasalazine had the lowest (.97). Methotrexate was the only other agent with an overall negative ratio (0.995), primarily due to concerns regarding side effects. Efficacy was the main reason for a positive sentiment and lack of efficacy was the most common reason for a negative sentiment. Side effects however also played a significant role in generating a negative sentiment especially about the csDMARDs. Most common emotions associated with a negative sentiment were a sense of hopelessness along with fear and uncertainty.  

Conclusion: Public opinion as expressed on social media is generally positive about the bDMARDs. Lack of efficacy is the biggest reason for a negative sentiment towards a medication, which often leads to a sense of hopelessness. A sense of fear and uncertainty play a role in generating this sense of hopelessness. Clinicians should be aware of this when dealing with patients who have failed a DMARD and provide cognitive reassurance to mitigate the pessimistic feelings that the patient might be experiencing.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/mining-social-media-data-to-investigate-patient-perceptions-regarding-dmard-pharmacotherapy-for-rheumatoid-arthritis/