An article published in the journal of Arthritis & Rheumatism (May 2013) reports that only about one third of the rheumatoid arthritis (RA) patients follow their prescribed medication regimens for non-biologic disease modifying anti-rheumatic drugs (DMARDs). Furthermore, only about one-fifth of RA patients actually were compliant to their prescribed oral medications at 80 percent or greater. This study was conducted in a low income and ethnically diverse group
The American College of Rheumatology (ARC) reports that about one million U.S. adults have inflammation, pain and joint swelling caused by RA.
Biologic therapies are often used with methotrexate (an oral DMARD) with great success, however, patients are often non-compliant with this regime. Biologic therapies include tumor necrosis factor (TNF) inhibitors such as adalimumab (Humira), etanercept (Enbrel) and infliximab (Remicade).
A recent two year study at The University of Texas MD Anderson Cancer Center conducted by Drs. C. Waimann and M. Suarez-Almaor has produced results on 107 RA patients and their compliance. They measured DMARD compliance for doses properly followed as a percentage of days or weeks for methotrexate or prednisone. They also measured underdosing and overdosing in the same manner.
This group of RA patients were ethnically diverse, with 65 percent Hispanic, 19 percent African-American and 16 percent Caucasian, where 45 percent were non-high school graduates and 67 percent had incomes of less than $20,000. Eighty-seven percent were females who had RA for 8 years.
Those patients who were compliant account for 64 percent for DMARD and 70 percent for prednisone.
This group of researchers also reports that 21 percent of the patients were compliant with their DMARD therapy and 41 percent to prednisone at least 80 percent of the time. It was also observed that patients who were compliant had lower disease activity scores during the study period, and patients who were non-compliant had increased radiological damage scores.
Waimann and Suarez-Almaor also report that oral DMARD and steroid therapy had low compliance ranging from 58 percent to 71 percent. This group of researchers indicates that patients with a sense of well being were more likely to be compliant. “Sense of well being” here refers to individuals who were not widowed or separated from a spouse.
Suarez-Almazor suggests that doctors need to understand their patients in terms of their reasoning for non-compliance and stress the importance of compliance to slow down the progression of RA.