Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Pain is a hallmark of rheumatoid arthritis (RA). The extent to which patient reported pain in RA is related to patterns of biologic treatment switching, change in physical function or work productivity has not been adequately explored. Understanding the impact of patient reported pain on these parameters has clinical relevance in the management of RA.
Objective: To investigate the impact of patient reported pain on biologic treatment switching, change in physical function and work productivity in patients with RA participating in the CORRONA registry.
Methods: The CORRONA registry is a network of rheumatology practices across the U.S. with patient and physician reported data on more than 30,000 patients with RA. To be included in the analysis, patients with RA had to initiate a biologic agent and remain on stable background RA therapy (no dose adjustments, discontinuations, additions or switching) for 6 months. Pain was assessed using a numeric rating scale from 0-10 with 10 defined as “pain as bad as it could be”. Pain levels reported at the visit following 6 months of stable RA therapy served as the baseline visit for the analysis. Outcomes assessed during the 12 month follow up period or at the 12 month follow up visit included: 1) frequency of biologic treatment switching; 2) frequency of biologic treatment switching due to inefficacy; 3) change from baseline in physical function as measured by the modified health assessment questionnaire (mHAQ); and 4) days lost from work due to RA. Separate multivariate analyses were performed for each outcome. Covariates considered for adjustment were age, gender, race, education status, smoking status, insurance status, baseline clinical disease activity index (CDAI), disease duration, baseline mHAQ, and comorbidities. Covariates were included in the model if they were biologically plausible and significantly associated with the outcome of interest in bivariate evaluations.
Results: 1180 patients with RA met the eligibility criteria and had a 12 month follow up visit after baseline. The majority were females (77.9%) and Caucasian (84.7%) with a mean age of 57.4 (SD ±12.4) years, mean pain 3.1 (SD ±2.5); mean disease duration 11.5 (SD ±9.9) years, mean CDAI 11.45 (SD ±10.7), and mean mHAQ score 0.4 (SD ±0.5). More than half had a college or university education while a small percentage reported smoking (16.8%). The most common comorbidities reported were history of malignancies (16.5%), cardiovascular disease (7.7%), peptic ulcer (7.3%) and diabetes (7.2%).
The adjusted association between patient reported pain and outcomes of interest are shown in Table 1. Odds Ratios (OR), Relative Risk Ratios (RRR) and Coefficients refer to change in outcome associated with a one unit increase in patient reported pain.
Conclusion: Patient reported pain in RA patients is associated with biologic treatment switches, reduction in function, and days lost from work.
Disclosure:
D. A. Pappas,
CORRONA Inc,
3,
Novartis Pharmaceutical Corporation,
5,
Columbia University,
6;
C. K. Karki,
Corrona, Inc.,
3;
C. Lee,
Eli Lilly and Company,
1,
Eli Lilly and Company,
3;
G. W. Reed,
CORRONA , Inc.,
3;
P. He,
UMASS Medical School,
3;
S. Al Sawah,
Eli Lilly and Company,
3.
« Back to 2013 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/patient-reported-pain-a-predictor-of-outcomes-in-rheumatoid-arthritis-from-the-consortium-of-rheumatology-researchers-of-north-america-registry/