Satisfaction and discontent of Polish patients with biological therapy of rheumatic diseases: results of the multi-center questionnaire study
Data nadesłania: 02-05-2018
Data ostatniej rewizji: 10-06-2018
Data akceptacji: 11-06-2018
Data publikacji online: 30-06-2018
Data publikacji: 30-06-2018
Reumatologia 2018;56(3):140-148
Biologics are medications widely applied in the management of inflammatory rheumatic diseases. The drugs were found to be effective but their application is associated with some disadvantages. Medication with biologics is relatively expensive, and in Poland, it is carried out in specialized centers. The study was designed to evaluate various aspects of satisfaction and dissatisfaction of Polish patients treated with biologics.

Material and methods:
An anonymous questionnaire was distributed in 23 Polish rheumatological centers involved in the treatment; 1212 returned questionnaires were used for analysis. Responses were received from 606 patients with rheumatoid arthritis, 427 with ankylosing spondylitis, 117 psoriatic arthritis, and 62 adult patients with juvenile idiopathic arthritis (in whom administration of the drugs had been introduced before they were 18 years old). The investigated group constituted about one-fifth of all rheumatic patients on biologics in Poland.

A beneficial or very beneficial influence of the medication on the state of physical health was found mostly in patients with rheumatoid arthritis (51.3 and 30.5%) and ankylosing spondylitis (51.0 and 36.8%). Family life was improved by the treatment especially in patients with ankylosing spondylitis (40.7 and 35.6% beneficial and very beneficial, respectively), sleep quality and sexual life mostly in those with ankylosing spondylitis (beneficial/very beneficial influence 41.5/38.4, and 38.7/23.9, respectively). There was a rather small influence of biological treatment on the financial situation of the patients. In general, satisfaction with the treatment was evaluated as positive or very positive in 88% of all investigated patients. In a significant part of the patients, transportation to the medical center was considered as a disadvantage of the treatment. About one-third of the patients considered laboratory and imaging tests to be done before initiation of the medication as a difficulty, and for about 40% waiting time for qualification for the medication was a significant disadvantage. The route of drug administration was without importance for 4/5 of the patients.

Summing up, the results were similar in the patients suffering from various diseases although those with psoriatic arthritis felt the highest satisfaction (possibly due to the positive aesthetic effect), and those with ankylosing spondylitis had significant improvement in sexual life (probably due to younger age). Relatively low satisfaction was found in patients with juvenile idiopathic arthritis. There was a small influence of medication on financial status of the patients. Application of biologics has few disadvantages and most of them are associated with the organization of health services (waiting time for the tests, transportation to the medical centers).

Smolen JS, Landewé R, Bijlsma J, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis 2017; 76: 960-977.
Nam JL, Takase-Minegishi K, Ramiro S, et al. Efficacy of biological disease-modifying antirheumatic drugs: a systematic literature review informing the 2016 update of the EULAR recommendations for the management of rheumatoid arthritis. Ann Rheum Dis 2017; 76: 1113-1136.
Ramiro S, Sepriano A, Chatzidionysiou K, et al. Safety of synthetic and biological DMARDs: a systematic literature review informing the 2016 update of the EULAR recommendations for management of rheumatoid arthritis. Ann Rheum Dis 2017; 76: 1101-1136.
Jeka S (ed.). 10 lat leczenia biologicznego chorób reumatycznych w Polsce. Termedia, Poznań 2017.
Guła Z, Stec M, Rutkowska-Zapała M, et al. The absolute number of circulating nonclassical (CD14+CD16++) monocytes negatively correlates with DAS28 and swollen joint count in patients with peripheral spondyloarthritis. Pol Arch Intern Med 2017; 127: 846-853.
Murray-Brown W, Wechalekar MD, Smith M. PD-1+ T cells contribute differently to the pathogenesis of rheumatoid arthritis and psoriatic arthritis. Pol Arch Intern Med 2017; 127: 813-814.
Bartosińska J, Zakrzewska E, Król A, et al. Differential expression of programmed death 1 (PD-1) on CD4+ and CD8+ T cells in rheumatoid arthritis and psoriatic arthritis. Pol Arch Intern Med 2017; 127: 815-822.
Przepiera-Będzak H, Fischer K, Brzosko M. Serum VEGF, EGF, basic FGF, and acidic FGF levels and their association with disease activity and extra-articular symptoms in ankylosing spondylitis. Pol Arch Med Wewn 2016; 126: 290-292.
Uthman I, Noureldine MH, Arayssi T, et al. How to treat ankylosing spondylitis and nonradiographic axial spondyloarthritis. Key practical message from the 2015 American College of Rheumatology recommendations. Pol Arch Med Wewn 2016; 126; 254-261.
Kucharz EK. Reumatoidalne zapalenie stawów. [In:] Wielka Interna – Reumatologia. Puszczewicz MJ (ed.). 2nd ed. Medical Tribune, Warszawa 2016: 79-951.
Ku JH, Danve A, Pang H, et al. Determinants of patient satisfaction in an academic rheumatology practice. J Clin Rheumatol 2015; 21: 256-262.
Kucharz EJ, Kotulska A, Kopeć-Mędrek M, et al. Opinion of patients with ankylosing spondylitis on risk factors impairing their quality of life. Rheumatol Int 2013; 33: 2899-2901.
Van Genderen S, Plasqui G, van der Heijde D, et al. Social role participation and satisfaction with life: a study among patients with ankylosing spondylitis and population controls. Arthritis Care Res (Hoboken) 2018; 70: 600-607.
Fan D, Liu L, Ding N, et al. Male sexual dysfunction and ankylosing spondylitis: a systematic review and metaanalysis. J Rheumatol 2015; 42: 252-257.
Liu YF, Dong H, Chen Z, et al. Impact of ankylosing spondylitis on sexual function: a systemic review and meta-analysis. Exp Ther Med 2015; 9: 1501-1507.
Dhakad U, Singh BP, Das SK, et al. Sexual disfunctions and lower urinary tract symptoms in ankylosing spondylitis. Int.
J Rheum Dis 2015; 18: 866-872.
Kucharz EJ. Reumatoseksuologia: wprowadzenie do problematyki interdyscyplinarnej. Reumatologia 2010; 48: 155-158.
Boonen A, Boone C, Albert A, et al. Understanding limitations in at-work productivity in patients with active ankylosing spondylitis: the role of work-related contextual factors. J Rheumatol 2015; 42: 93-100.
Urruticoechea-Arana A, Serra Torres M, Hergueta Diaz M, et al. Experience and satisfaction with a multidisciplinary care unit for patients with Psoriasis and psoriatic arthritis. Reumatol Clin 2017; pii: S1699-258X(17)30183-3 [Epub ahead of print].
González CM, Carmona L, de Toro J, et al. Perceptions of patients with rheumatic diseases on the impact on daily life and satisfaction with their medications: RHEU-LIFE, a survey to patients treated with subcutaneous biological products. Patient Prefer Adherence 2017; 11: 1243-1252.
Husni ME, Merola JF, Davin S. The psychosocial burden of psoriatic arthritis. Semin Arthritis Rheum 2017; 47: 351-360.
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