Treatment satisfaction higher for patients with rheumatoid arthritis choosing their own treatment

by Elana Gotkine

edited by Gaby Clark, reviewed by Andrew Zinin

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For patients with rheumatoid arthritis (RA), those choosing their own treatment have higher treatment satisfaction, better treatment retention and fewer reported adverse events, according to a study published online Oct. 27 in RMD Open.

Floor L. Reimann, M.D., from Frisius Medical Centre in Leeuwarden, Netherlands, and colleagues conducted a multicenter randomized trial involving patients with biologic disease-modifying antirheumatic drug–naive RA. One hundred two patients were randomly assigned to personally choose between a subcutaneous tumor necrosis factor inhibitor (TNFi) and the oral Janus kinase inhibitor (JAKi) filgotinib or to be randomly assigned to the same treatment options.

In the patient-choice group, 55% and 45% chose JAKi treatment and subcutaneous TNFi, respectively (28 and 23 patients). The researchers found that treatment satisfaction was significantly higher at 24 weeks in the patient-choice group versus the randomized group. Fewer patients in the patient-choice group switched to a different mode of action by week 12 versus the randomized group.

At week 24, the mean Disease Activity Score in 28 joints using erythrocyte sedimentation rate was numerically lower in the patient-choice group, but the difference was not statistically significant. The randomized group used more glucocorticoids at week 12 and had a significantly higher number of adverse events per patient.

"Our results underscore the importance of patient participation and shared decision-making," the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

More information

Floor L Reimann et al., Better After CHoosing in rheumatoid arthritis (the BACH trial): patients who have the opportunity to choose their treatment are more satisfied, RMD Open (2026). DOI: 10.1136/rmdopen-2026-007406

Key medical concepts

Rheumatoid ArthritisAdverse Event

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Rheumatology Who's behind this story?

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