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Preferences for Tapering Biologic Disease-Modifying Antirheumatic Drugs Among People With Rheumatoid Arthritis: A
Suz Jack Chan1, Lisa K Stamp2, Gareth J Treharne1
1University of Otago, Dunedin, New Zealand.
Arthritis Care & Research
|September 23, 2024
Summary
Patients with rheumatoid arthritis (RA) favor tapering biologic disease-modifying antirheumatic drugs (bDMARDs), prioritizing reduced dosing frequency over increased risk of disease flare. Shared decision-making can enhance treatment plans.
Area of Science:
- Rheumatology
- Pharmacoeconomics
- Patient-reported outcomes
Background:
- Biologic disease-modifying antirheumatic drugs (bDMARDs) are crucial in managing rheumatoid arthritis (RA).
- Tapering strategies for bDMARDs are increasingly explored, but patient preferences remain under-researched.
- Understanding patient perspectives is vital for optimizing RA treatment regimens.
Purpose of the Study:
- To assess patient preferences for tapering bDMARDs in RA.
- To identify key factors influencing decisions regarding bDMARD dose reduction.
- To explore the impact of treatment benefits and risks on patient choices.
Main Methods:
- An online discrete choice experiment was conducted with RA patients experienced in bDMARD therapy.
- Participants evaluated hypothetical scenarios varying dosing frequency, risk of adverse effects, and disease control.
- Preference weights were estimated using a multinomial logit model.
Main Results:
- Reduced dosing frequency was the most significant factor influencing patient preference for bDMARD tapering.
- Patients were willing to accept a higher risk of disease flare in exchange for tapering benefits.
- Higher quality of life correlated with a preference for maintaining current treatment levels.
Conclusions:
- Dosing frequency and risk of disease flare are primary considerations for RA patients deciding on bDMARD tapering.
- Patient-centered shared decision-making can improve the implementation of bDMARD tapering strategies.
- The high predicted uptake suggests bDMARD tapering is a favored option among RA patients.
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