Patients’ and rheumatologists’ perceptions on preventive intervention in rheumatoid arthritis and axial spondyloarthritis

Arthritis Research & Therapy

Janne W. Bolt¹  Henriëtte M. de Jong¹  Marleen G. van de Sande¹  Marieke M. ter Wee²  Laurette van Boheemen³  Dirkjan van Schaardenburg⁴ 

[1] Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology & Immunology Center (ARC), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands;Department of Rheumatology, Amsterdam Rheumatology & Immunology Center (ARC), Amsterdam UMC, VUmc, Amsterdam, the Netherlands;Department of Epidemiology and Biostatistics, Amsterdam UMC, VUmc, Amsterdam, the Netherlands;Department of Rheumatology, Amsterdam Rheumatology & Immunology Center (ARC)—Reade, PO box 58271, 1040 HG, Amsterdam, the Netherlands;Department of Rheumatology, Amsterdam Rheumatology & Immunology Center (ARC)—Reade, PO box 58271, 1040 HG, Amsterdam, the Netherlands;Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology & Immunology Center (ARC), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands;

关键词: Rheumatoid arthritis;    Axial spondyloarthritis;    Primary prevention;    Lifestyle intervention;    Preventive medication;   

DOI  :  10.1186/s13075-020-02314-9

来源: Springer

【 摘 要 】

BackgroundIndividuals at risk of developing rheumatoid arthritis (RA) may benefit from lifestyle or pharmacological interventions aimed at primary prevention. The same may apply to individuals at risk of axial spondyloarthritis (axSpA). Our aim was to investigate and compare the willingness of individuals at risk of RA or axSpA and rheumatologists to initiate preventive intervention.MethodsIndividuals at risk of RA (arthralgia and anti-citrullinated protein antibodies and/or rheumatoid factor positivity without arthritis (RA-risk cohort; n = 100)), axSpA (first-degree relatives of HLA-B27-positive axSpA patients (SpA-risk cohort; n = 38)), and Dutch rheumatologists (n = 49) completed a survey on preventive intervention which included questions about disease perception, lifestyle intervention, and preventive medication.ResultsAt-risk individuals reported willingness to change median 7 of 13 lifestyle components in the areas of smoking, diet, and exercise. In contrast, 35% of rheumatologists gave lifestyle advice to ≥ 50% of at-risk patients. The willingness to use 100% effective preventive medication without side effects was 53% (RA-risk), 55% (SpA-risk), and 74% (rheumatologists) at 30% disease risk which increased to 69% (RA-risk) and 92% (SpA-risk and rheumatologists) at 70% risk. With minor side effects, willingness was 26%, 29%, and 31% (at 30% risk) versus 40%, 66%, and 76% (at 70% risk), respectively.ConclusionsRisk perception and willingness to start preventive intervention were largely similar between individuals at risk of RA and axSpA. Although the willingness to change lifestyle is high among at-risk individuals, most rheumatologists do not advise them to change their lifestyle. In contrast, rheumatologists are more willing than at-risk patients to start preventive medication.

【 授权许可】

CC BY