THU0363 A Structured Literature Review of the Burden of Illness and Unmet Needs in Patients with Rheumatoid Arthritis: A Current Perspective

BackgroundDespite improvements in the attainable clinical and health outcomes for patients with rheumatoid arthritis (RA), the goals of remission or low disease activity still remain difficult to achieve in a substantial proportion of patients. While rheumatologists have focussed on attainment of these goals, for many patients, particularly those who do not achieve these targets, additional treatment goals are control over pain and fatigue, as well as maintaining physical function and quality of life (QoL).ObjectivesTo examine patients' treatment aspirations and to identify the unmet needs for patients with RA receiving ongoing treatment and the associated humanistic and economic burden.MethodsSearches were performed using MEDLINE, Embase, PsycINFO and Econlit literature databases for articles published from 2004–2014 in the English language. Published literature was screened to identify articles reporting the burden of RA in patients receiving ongoing treatment. Core search terms included those related to the condition of study and treatment, and were combined with search terms related to humanistic and economic burden.ResultsA total of 3212 articles were identified. After removing conference abstracts and duplicates and screening titles and abstracts, 77 publications that reported on the humanistic (68 articles) and economic burden (9 articles) of RA were selected for full text review. Despite clinically meaningful improvements in pain with the introduction of effective treatment algorithms, patient scores remained below the acceptable threshold in those receiving biologic therapy (1), whereas patients with RA receiving ongoing treatment with conventional disease-modifying antirheumatic drugs continued to experience moderate pain (2). Other health outcomes such as physical disability persisted above the threshold that patients would consider acceptable (3, 4) and mental health needs were also insufficiently met in a large proportion of patients with RA receiving ongoing treatment (5). In Europe, the health burden of RA was associated with an economic burden of € 45.3 billion, affecting patients, their families and society (6).ConclusionsDespite ongoing advances in the treatment of RA, many patients receiving currently available therapies continue to experience substantial disability and suboptimal QoL. RA is a multifaceted disease that can impact on individual patients in a variety of ways, some objectively evident and others known only to the patient th