AFP SURVEY: OBSERVATIONAL SURVEY ON THE TREATMENT EXPECTATIONS IN PATIENTS WITH RHEUMATOID ARTHRITIS (RA) AND THEIR RHEUMATOLOGIST

Background: Effective new drugs are now available for the RA treatment and they change its goals: we are now aiming at "remission" but we don't know what this objective means for the RA patients.Objectives: The aim of our survey was to know what the treatment expectations of the French RA patients are and what expectations they think their rheumatologist have.Methods: We built a questionnaire in order to assess the French RA patients' actual life, their opinion regarding RA treatment, their expectations and those they think their rheumatologist has. Medical information and patients opinion were collected through a self-questionnaire sent to 1501 volunteer members of the main French RA patients association (Association Française des Polyarthritiques or AFP). This national cross-sectionnal survey was performed between September and December 2005.Results: More than 43% of the questionnaires (n = 651) could be retrieved (58,8% conventional DMARDs and 32,5% biotherapy). The mean age was 60. Nearly two-third were married (69,1%), with children in more than 9 cases out of 10 (93,1%). Nearly half of them stopped working because of their illness (51,7%). The mean number of joints with pain is 10,9 and 85,6% of the patients have a Rheumatoid Factor positive. More than 70% of the RA patients with biotherapy and more than 60% of those with conventional DMARDs are taking corticosteroids. The percentage of patients who had received 3 or more DMARDs is 39% in biotherapy group and 25% in conventional DMARDs group.The main goal of the treatment for these RA patients is to alleviate the joint pain: 68,4% in biotherapy group and 72,6% in conventional DMARDs group. The following therapeutic goals are: to protect the joints (42,5% and 44,4% respectively) and to return to a normal lifestyle (43,4% and 37,3%). These goals are mainly in line with the expectations they think their rheumatologist has. The main disadvantage of RA treatment is the frequency of adverse events (45,3% and 43,6% respectively). The following disadvantages are different between the 2 groups: the heavy cost and the impossibility to stop corticosteroids for the biotherapy group; the impossibility to stop corticosteroids and insufficient efficacy for the conventional DMARDs group (which is in accordance with what patients think the main concern of their rheumatologist is). The majority of these patients agree with having a treatment through injection if it brings them betterment, but they worry about two problems: the frequency of the injections and the place where they are carried out. The majority of them are waiting for a treatment with less adverse events, a longer remission period, a superior efficacy on the joint protection and which brings the opportunity to stop corticosteroids.Conclusion: This survey shows that the main objective of RA patients is to be relieved of their joint pain and that they are expecting a lot of improvment in the treatment of RA. They worry about the adverse events of the DMARDs and the difficulty to stop corticosteroids. These matters seem to meet their rheumatologist's ones.References: Supported by Roche Pharma, France.Citation: Ann Rheum Dis, volume 65, supplement II, year 2006, page 169Session: Rheumatic arthritis – other clinical aspects and comorbidity