Treatment Satisfaction, Patient Preferences, and the Impact of Suboptimal Disease Control in a Large International Rheumatoid Arthritis Cohort: SENSE Study

Figures & data

Table 1 Sociodemographic Characteristics

Characteristics	Full Analysis Set (n=1624)
Female, n (%)	1368 (84.2)
Age, years, mean (SD)	58.4 (13.1)
Race, n (%)
White	1431 (88.1)
Black	7 (0.4)
Asian	139 (8.6)
Mixed	46 (2.8)
Other	1 (0.1)
Occupation, n (%)
Employed full-time	426 (26.2)
Employed part-time (not due to RA)	28 (1.7)
Employed part-time due to RA	53 (3.3)
Attending school or university	12 (0.7)
Unemployed (not due to RA)	163 (10.0)
Unemployed due to RA	97 (6.0)
Early retired (not due to RA)	87 (5.4)
Early retired due to RA	194 (11.9)
Regularly retired	549 (33.8)
Education, n (%)
No formal education	27 (1.7)
Primary school	388 (23.9)
Secondary school (eg high school)	633 (39.0)
Non-university, professional education	311 (19.2)
University	263 (16.2)
Residence, n (%)
Urban center (>80,000 inhabitants)	814 (50.1)
Town (10,000–80,000 inhabitants)	432 (26.6)
Rural area (<10,000 inhabitants)	378 (23.3)

Abbreviations: RA, rheumatoid arthritis; SD, standard deviation.

Table 2 Rheumatoid Arthritis Disease Activity and Joint Assessment

Measure, Mean (SD)	Full Analysis Set (n=1624)^a
TJC28 (0–28)	7.8 (5.4)
SJC28 (0–28)	4.6 (4.2)
PtGA (VAS, 0–10 cm)	5.7 (2.1)
PhGA (VAS, 0–10 cm)	5.2 (1.9)
DAS28-CRP^b	4.7 (1.1)
DAS28-ESR^c	5.0 (1.1)
CDAI (0–76)	23.3 (10.6)
SDAI (0–86)^b	26.9 (12.9)

Notes: ^aUnless otherwise stated. ^bn=1500 patients with valid data. ^cn=1515 patients with valid data.

Abbreviations: CDAI, Clinical Disease Activity Index; DAS28-CRP, Disease Activity Score in 28 joints with C-reactive protein; DAS28-ESR, Disease Activity Score in 28 joints with erythrocyte sedimentation rate; PhGA, Physician Global Assessment; PtGA, Patient Global Assessment; SD, standard deviation; SDAI,Simplified Disease Activity Index; SJC28, swollen joint count in 28 joints; TJC28, tender joint count in 28 joints; VAS, visual analog scale.

Table 3 Current Medications Administered for Rheumatoid Arthritis

Medication, n (%)	Full Analysis Set (n=1624)
csDMARD	1447 (89.1)
Methotrexate	991 (61.0)
Leflunomide	363 (22.4)
Hydroxychloroquine	244 (15.0)
Sulfasalazine	212 (13.1)
Chloroquine	22 (1.4)
bDMARD	530 (32.6)
Adalimumab	116 (7.1)
Etanercept	115 (7.1)
Rituximab	73 (4.5)
Tocilizumab	72 (4.4)
Abatacept	52 (3.2)
Infliximab	39 (2.4)
Certolizumab pegol	32 (2.0)
Golimumab	30 (1.8)
tsDMARD	39 (2.4)
Tofacitinib	34 (2.1)
Baricitinib	5 (0.3)
Systemic glucocorticoids	163 (10.0)

Abbreviations: bDMARD, biologic DMARD; csDMARD, conventional synthetic DMARD; DMARD, disease-modifying antirheumatic drug; tsDMARD, targeted synthetic DMARD.

Figure 1 Mode of action for planned DMARD switches.

Note: Treatment switch to a different DMARD was planned for 840 patients (51.8%) out of 1623 patients with valid data.

Abbreviations: bDMARD, biologic DMARD; csDMARD, conventional synthetic DMARD; DMARD, disease-modifying antirheumatic drug; IL-6, interleukin-6; JAK, Janus kinase; TNF, tumor necrosis factor.

Figure 2 Treatment Satisfaction Questionnaire for Medication subscores.

Notes: Full analysis set (n=1624). Each TSQM subscore ranges from 0 to 100, with higher scores denoting greater satisfaction.

Abbreviations: SD, standard deviation; TSQM, Treatment Satisfaction Questionnaire for Medication.

Table 4 Predictors of Good Treatment Satisfaction (TSQM Global Satisfaction Score ≥80)

Variables	Effect Estimate	P-value^a	OR (95% CI)
High disease activity (DAS28-ESR >5.1)	−0.6045	0.0026	0.546 (0.368, 0.810)
SF-36 PCS	0.0554	<0.0001	1.057 (1.036, 1.078)
SF-36 MCS	0.0340	<0.0001	1.035 (1.019, 1.050)
Psychiatric disorders	0.9475	0.0004	2.579 (1.531, 4.344)
Current treatment with ts/bDMARDs	1.2665	<0.0001	3.548 (2.593, 4.856)

Note: ^aChi-square test, multivariate logistic regression model using the full analysis set (n=1624).

Abbreviations: bDMARD, biologic DMARD; CI, confidence interval; DAS28-ESR, Disease Activity Score in 28 joints with erythrocyte sedimentation rate; DMARD, disease-modifying antirheumatic drug; MCS, Mental Component Summary; OR, odds ratio; PCS, Physical Component Summary; SF-36, 36-item Short Form Health Survey; tsDMARD, targeted synthetic DMARD; TSQM, Treatment Satisfaction Questionnaire for Medication.

Table 5 Patient-Reported Outcomes

Patient-Reported Outcome	n^a	Mean (SD)^b
Worst joint pain (0–10)	1623	6.0 (2.5)
Severity of morning stiffness (0–10)	1623	5.0 (2.8)
Duration of morning stiffness, hours, median (IQR)	1488	1.0 (0.5–2.0)
FACIT-F score (0–52)	1623	28.1 (11.2)
HAQ-DI score (0–3)	1624	1.3 (0.7)
SF-36 PCS (0–100)	1623	36.6 (7.9)
SF-36 MCS (0–100)	1623	41.9 (11.0)
WPAI-RA scores, %, median (IQR)
Presenteeism^c	418	40.0 (20.0–70.0)
Absenteeism^c	461	0.0 (0.0–16.7)
Total work productivity impairment^c	413	50.0 (20.0–70.0)
Total activity impairment	1619	60.0 (30.0–80.0)

Notes: ^aValid data from the full analysis set (n=1624). ^bUnless otherwise stated. ^cEmployed patients only.

Abbreviations: FACIT-F, Functional Assessment of Chronic Illness Therapy-Fatigue; HAQ-DI, Health Assessment Questionnaire-Disability Index; IQR, interquartile range; MCS, Mental Component Summary; PCS, Physical Component Summary; SD, standard deviation; SF-36, 36-item Short Form Health Survey; WPAI-RA, Work Productivity and Activity Impairment-Rheumatoid Arthritis.

Figure 3 Patients’ expectations for RA treatments.

Notes: Patients scored their expectations based on a 7-point numeric rating scale where 1 = no improvement needed to 7 = the most improvement needed. The mean (SD) score and distribution of scores are shown for each treatment expectation. Due to rounding, percentages may not sum to 100%.

Abbreviations: RA, rheumatoid arthritis; SD, standard deviation.

Figure 4 Patients’ preferences for RA treatments: (A) route of administration, drug combinations, and time to effect; (B) acceptability of potential side effects of RA treatments.

Note: (B) n=1608.

Abbreviations: CVD, cardiovascular disease; RA, rheumatoid arthritis.

Figure 5 Patients’ need for patient support programs.

Notes: Patients scored their perceived need for PSP items based on a 7-point numeric rating scale where 1 = not needed at all to 7 = very much needed. Patients received a short description of PSPs as part of the questionnaire. The mean (SD) score and distribution of scores are shown for each PSP item. Due to rounding, percentages may not sum to 100%.

Abbreviations: PSP, patient support program; RA, rheumatoid arthritis; SD, standard deviation.