Large numbers of people with severe rheumatoid arthritis are failing to take expensive medication as prescribed, according to a new multi-centre study led by researchers in Manchester.
Twenty seven per cent of rheumatoid arthritis patients in the study who were on a class of drugs known as anti-TNF therapies did not take them as prescribed in the first six months. Patients from Manchester Royal Infirmary were among those from 60 hospitals around the UK involved in the study.
Researchers from the Arthritis Research UK Centre for Genetics and Genomics at The University of Manchester, who led the study, warned that failure to take the drugs correctly, known as ‘non-adherence’, reduced their effectiveness and may lead to a worsening of patients’ disease.
Their results are published today (August 28 2014) in the journal Rheumatology.
One of the study’s authors, Dr Kimme Hyrich, reader in rheumatology at The University of Manchester and honorary consultant at Manchester Royal Infirmary added: “If patients do not take their medication as prescribed it is likely to have a significant effect on whether they respond to therapy and could mean that their condition deteriorates more quickly affecting their quality of life. Non-adherence is also a waste of scarce healthcare resources and something that needs to be addressed.”
It is not clear from the study whether patient’s non-adherence was deliberate or accidental, but for many patients with this chronic disease, it is expected that they will need to remain on these therapies for many years. Research is ongoing to try and understand more about the reasons why patients with arthritis may not always take their medications as prescribed.
Rheumatoid arthritis affects around 400,000 people in the UK and is caused by the body’s immune system turning on itself, leading to inflammation pain and swelling in the joints and other internal organs.
The development by Arthritis Research-funded scientists of biologic drugs such as anti-TNF therapy, which block the tumour necrosis factor (TNF) pathway in the inflammatory process that causes rheumatoid arthritis has revolutionised treatment worldwide in the past 10-15 years, and transformed the lives of millions of patients.
But it is expensive, costing between £8,000 and £12,000 a year per patient.
Professor Alan Silman, medical director of Arthritis Research UK, said: “Anti-TNF drugs have transformed the lives of a substantial number of patients with rheumatoid arthritis and related disorders. This success has been at a considerable cost to the NHS but there was always the assumption that patients prescribed these drugs will have the necessary regular injections. The fact that a considerable proportion of patients are missing doses of these very expensive agents is worrying, as clearly their effectiveness would be reduced.”
Researchers collected adherence data for 286 patients attending 60 rheumatology clinics across the UK between 2008 and 2012 who had rheumatoid arthritis for seven years. Of these, 27 per cent reported non-adherence to biologic therapy according to the defined criteria at least once over the first six-month period.
Self-reported non-adherence, defined as whether a dose of anti-TNF therapy is taken on the day agreed with the health professional, was recorded at three and six months.
The study captured data from patients attending 60 different hospitals across the UK and was funded by Arthritis Research UK and the Manchester National Institute for Health Research Manchester Musculoskeletal Biomedical Research Unit.
Notes for editors
For more information or to speak to a member of the research team please contact Jane Tadman in the Arthritis Research UK press office on 01246 541107/078974 203828 or firstname.lastname@example.org or Alison Barbuti, media relations officer in the Faculty of Medical and Human Sciences in The University of Manchester on 0161 275 8383 / 07887 561 318 email@example.com
About Arthritis Research UK
Arthritis Research UK is the charity dedicated to stopping the devastating impact that arthritis has on people’s lives. Everything that we do is focused on taking the pain away and keeping people active. Our remit covers all conditions which affect the joints, bones and muscles including osteoarthritis, rheumatoid arthritis, back pain and osteoporosis. We fund research into the cause, treatment and cure of arthritis, provide information on how to maintain healthy joints and bones and to live well with arthritis. We also champion the cause, influence policy change and work in partnership with others to achieve our aims. We depend on public support and the generosity of our donors to keep doing this vital work.
The University of Manchester, a member of the prestigious Russell Group of British universities, is the largest and most popular university in the UK. It has 20 academic schools and hundreds of specialist research groups undertaking pioneering multi-disciplinary teaching and research of worldwide significance. According to the results of the 2008 Research Assessment Exercise, The University of Manchester is one of the country’s major research institutions, rated third in the UK in terms of ‘research power’, and has had no fewer than 25 Nobel laureates either work or study there. The University had an annual income of £807 million in 2011/12. www.manchester.ac.uk
The NIHR Manchester Musculoskeletal Biomedical Research Unit was created by the National Institute for Health Research in 2012 to move scientific breakthroughs in the laboratory, through clinical assessment into improved outcomes for adults and children with musculoskeletal disorders such as arthritis. As a partnership between Central Manchester University Hospitals NHS Foundation Trust and The University of Manchester, the Biomedical Research Unit is designated as a specialist centre of excellence in musculoskeletal diseases. www.manchestermskbru.org
The National Institute for Health Research The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world.