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A Systematic Literature Review of Residual Symptoms and Unmet Need in Patients with Rheumatoid Arthritis.
Arthritis Care Res (Hoboken). 2020 Jul 03 [Online ahead of print]AC

Abstract

OBJECTIVE

To evaluate the nature and burden of residual disease in rheumatoid arthritis (RA) in patients who meet treatment targets. Secondly, for those who did not meet targets, evaluate how much is due to patient symptoms.

METHODS

Prospective and retrospective studies were searched in MEDLINE, Embase, and Cochrane Library in the English language from January 1, 2008, to April 18, 2018; conference abstracts (from January 2016 to April 2018) and reference lists of relevant studies were also screened.

RESULTS

Of 8,339 records identified, 55 were included in the review; 53 were unique studies, including 10 randomized controlled trials. Of these, 48 reported on patients who achieved low disease activity (LDA) or remission. Studies varied in population, treatment goals, and outcome reporting. The proportions of patients with residual symptoms in these studies varied by the definitions used for LDA or remission and were more often reported in patients with LDA than those in remission. The most commonly reported outcome measures were functional disability (n=34 studies), tender or swollen joints (n=18), pain (n=17), patient global assessment (n=15), and fatigue (n=14). However, few studies reported the percentage of patients achieving a specific threshold, which could then be used to easily define the presence of residual symptoms.

CONCLUSION

Residual symptoms are present in some patients despite their achieving LDA or remission, highlighting an unmet need, especially with respect to improving pain, fatigue, and function. Standardized reporting in future observational studies would facilitate better understanding of this issue in defined RA populations.

Authors+Show Affiliations

University of Nebraska Medical Center, Omaha, NE, United States. The National Databank for Rheumatic Diseases, Wichita, KS, United States.University of Western Ontario, London, ON, N6A 4V2, Canada.No affiliation info availableUniversity of Twente, Enschede, the Netherlands.University of Alabama at Birmingham, Birmingham, AL, United States.Eli Lilly and Company, Indianapolis, IN, USA.RTI Health Solutions, Manchester, UK.RTI Health Solutions, Manchester, UK.Eli Lilly and Company, Indianapolis, IN, USA.RTI Health Solutions, Manchester, UK.RTI Health Solutions, Manchester, UK.Botnar Research Centre, University of Oxford, Oxford, OX3 7LD, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32619340

Citation

Michaud, Kaleb, et al. "A Systematic Literature Review of Residual Symptoms and Unmet Need in Patients With Rheumatoid Arthritis." Arthritis Care & Research, 2020.
Michaud K, Pope J, van M, et al. A Systematic Literature Review of Residual Symptoms and Unmet Need in Patients with Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2020.
Michaud, K., Pope, J., van, M., de Laar, ., Curtis, J. R., Kannowski, C., Mitchell, S., Bell, J., Workman, J., Paik, J., Cardoso, A., & Taylor, P. C. (2020). A Systematic Literature Review of Residual Symptoms and Unmet Need in Patients with Rheumatoid Arthritis. Arthritis Care & Research. https://doi.org/10.1002/acr.24369
Michaud K, et al. A Systematic Literature Review of Residual Symptoms and Unmet Need in Patients With Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2020 Jul 3; PubMed PMID: 32619340.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Systematic Literature Review of Residual Symptoms and Unmet Need in Patients with Rheumatoid Arthritis. AU - Michaud,Kaleb, AU - Pope,Janet, AU - van,Mart, AU - de Laar,, AU - Curtis,Jeffrey R, AU - Kannowski,Carol, AU - Mitchell,Sarah, AU - Bell,Judith, AU - Workman,Jennifer, AU - Paik,Jim, AU - Cardoso,Anabela, AU - Taylor,Peter C, Y1 - 2020/07/03/ PY - 2020/7/4/entrez PY - 2020/7/4/pubmed PY - 2020/7/4/medline KW - Rheumatoid arthritis KW - fatigue KW - low disease activity KW - pain KW - patient reported outcome measures KW - remission KW - residual symptom KW - systematic review KW - treat to target JF - Arthritis care & research JO - Arthritis Care Res (Hoboken) N2 - OBJECTIVE: To evaluate the nature and burden of residual disease in rheumatoid arthritis (RA) in patients who meet treatment targets. Secondly, for those who did not meet targets, evaluate how much is due to patient symptoms. METHODS: Prospective and retrospective studies were searched in MEDLINE, Embase, and Cochrane Library in the English language from January 1, 2008, to April 18, 2018; conference abstracts (from January 2016 to April 2018) and reference lists of relevant studies were also screened. RESULTS: Of 8,339 records identified, 55 were included in the review; 53 were unique studies, including 10 randomized controlled trials. Of these, 48 reported on patients who achieved low disease activity (LDA) or remission. Studies varied in population, treatment goals, and outcome reporting. The proportions of patients with residual symptoms in these studies varied by the definitions used for LDA or remission and were more often reported in patients with LDA than those in remission. The most commonly reported outcome measures were functional disability (n=34 studies), tender or swollen joints (n=18), pain (n=17), patient global assessment (n=15), and fatigue (n=14). However, few studies reported the percentage of patients achieving a specific threshold, which could then be used to easily define the presence of residual symptoms. CONCLUSION: Residual symptoms are present in some patients despite their achieving LDA or remission, highlighting an unmet need, especially with respect to improving pain, fatigue, and function. Standardized reporting in future observational studies would facilitate better understanding of this issue in defined RA populations. SN - 2151-4658 UR - https://www.unboundmedicine.com/medline/citation/32619340/A_Systematic_Literature_Review_of_Residual_Symptoms_and_Unmet_Need_in_Patients_with_Rheumatoid_Arthritis L2 - https://doi.org/10.1002/acr.24369 DB - PRIME DP - Unbound Medicine ER -
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