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Patient preferences for rheumatoid arthritis treatment

Hsiao, Bettya; Fraenkel, Lianaa,b

Current Opinion in Rheumatology: May 2019 - Volume 31 - Issue 3 - p 256–263
doi: 10.1097/BOR.0000000000000591

Purpose of review To provide an overview of recent articles discussing patient preferences for rheumatoid arthritis (RA) treatment.

Recent findings Recent studies examined patient preferences for RA treatment in several populations, finding that most participants were willing to accept certain risks of adverse effects to gain potential benefits. Perspectives regarding cannabis were studied, with patients describing medical marijuana as an alternative therapy to be used with prescription medications or as means of tapering off these medications. Treatment preferences for different RA therapies were explored using a conjoint analysis survey and five distinct preference phenotypes emerged, with members of the largest group most concerned with the cost of medications. Other discrete choice studies demonstrated route of administration as an important attribute influencing treatment preferences, with patients expressing preference for various modes in different studies. Patient preferences for route of administration have demonstrated preference for newer autoinjectors over prefilled syringes as well as currently marketed autoinjectors. Incorporating patient preferences in clinical practice recommendations was described in the development of the 2015 American College of Rheumatology (ACR) RA treatment guidelines as well as the 2017 ACR/American Association of Hip and Knee Surgeons guidelines for perioperative management of antirheumatic medications. In addition, other studies explored preferences with regard to predictive testing, medication intensification and tapering, treatment goals, and psychological support.

Summary Our review of recent studies show variability in patient preferences for RA treatment, highlighting the importance of incorporating patient input into the treatment approach.

aYale University School of Medicine, New Haven

bVA Connecticut Healthcare System, West Haven, Connecticut, USA

Correspondence to Betty Hsiao, MD, Section of Rheumatology, Yale University School of Medicine, 300 Cedar St, TAC Bldg, RM #525, PO Box 208031, New Haven, CT 06520-8031, USA. Tel: +1 203 785 2453; fax: +1 203 785 7053; e-mail:

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