Effect of medication adherence on disease activity among Japanese patients with rheumatoid arthritis

DOI HANDLE Web Site 30 References Open Access
  • Nakagawa, Shunsaku
    Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital
  • Nakaishi, Mayumi
    Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital
  • Hashimoto, Motomu
    Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University
  • Ito, Hiromu
    Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University
  • Yamamoto, Wataru
    Department of Health Information Management, Kurashiki Sweet Hospital
  • Nakashima, Ran
    Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University
  • Tanaka, Masao
    Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University
  • Fujii, Takao
    Department of Clinical Immunology and Rheumatology, Wakayama Medical University
  • Omura, Tomohiro
    Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital
  • Imai, Satoshi
    Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital
  • Nakagawa, Takayuki
    Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital
  • Yonezawa, Atsushi
    Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital
  • Imai, Hirohisa
    Graduate School of Medicine, Department of Medical and Pharmaceutical Community Healthcare, the University of Tokyo
  • Mimori, Tsuneyo
    Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University
  • Matsubara, Kazuo
    Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital
  • Masataka Kuwana
    editor

Abstract

For the optimum efficacy of disease-modifying anti-rheumatic drugs (DMARDs), patients need to be adherent to their medication regimen. To clarify the effects of medication adherence on disease activity in Japanese patients with rheumatoid arthritis (RA), we conducted a cohort study in patients with various stages of RA. Patients were enrolled from the Kyoto University RA Management Alliance cohort, and followed up prospectively for 12 months. In this study, a total of 475 patients were analyzed and divided into 9 groups according to their medication adherence and the RA disease duration. The primary outcomes were based on the rate of a disease flare. The secondary outcomes were the changes in disease activity score using 28 joints (DAS28-ESR), simplified disease activity index (SDAI) and physical disability by health assessment questionnaire-disability index (HAQ). The changes in DAS28-ESR, HAQ, and the risk of disease flare in the highly adherent patients were significantly lower than those of the less adherent patients among the groups with RA ≤ 4.6 years but not those among the other groups. Taken together, this study identified a significant association between medication adherence and the disease flare during early-stage RA or short disease duration. These results emphasize the need to pay more attention to medication adherence in preventing the disease progression of RA.

Journal

  • PLOS ONE

    PLOS ONE 13 e0206943-, 2018-11-02

    Public Library of Science (PLoS)

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