Real-world study exposes suboptimal adherence to treat-to-target rheumatic strategies
· News-MedicalIn a smaller proportion, non-adherence was due to failure to adapt therapy to disease activity results. The authors also looked to see whether any particular clinical characteristics were linked with rates of T2T adherence. Across all diagnoses, treatment with ts/bDMARDs was strongly associated with better adherence to the strategy. Interestingly, younger age was associated with T2T adherence in rheumatoid arthritis and spondyloarthritis, but not in psoriatic arthritis. Disease duration and number of comorbidities did not show a statistical association.
Giorgia Trignani, University of MilanThese findings highlight potential pitfalls for T2T in clinical practice - and possibly ways to improve implementation and adherence."
To do this, Eve Caroline Berthouzoz and colleagues conducted repeated cross-sectional analyses using visit-level data from patients in the Swiss Clinical Quality Management (SCQM) registry; overall, 5,523 visits from 3,983 patients with documented smoking status were included. The results show that current smoking prevalence among Swiss patients with rheumatoid arthritis parallels the national decline: falling from 18.5% in 2012 to 15.1% in 2022, compared with 28.2% and 23.9% in the Swiss general population, respectively.
However, among men with rheumatoid arthritis, ever smoking prevalence increased from 2012 to 2022 (64.9% to 68.8%), but it declined in the general population (57.0% to 51.4%). Yet among women with rheumatoid arthritis, rates of those who had ever smoked remained consistently lower than in the general population. Age- and education-adjusted analyses confirmed an increasing excess of lifetime smoking exposure - specifically among men with rheumatoid arthritis compared with the general population. This widening gap is consistent with smoking being a risk factor for rheumatoid arthritis, and suggests that population-level primary prevention efforts in Switzerland have been less effective in men who subsequently develop RA.
These four abstracts highlight the value of real-world data in RMD. These evidence sources are increasingly used to inform and guide clinical decision-making.
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