OBJECTIVES: ACR 2015 guidelines for treating Rheumatoid Arthritis (RA) suggest that treatment decisions should be made by physicians and patients through a shared decision-making process METHODS: A multi-center medical chart review of RA patients who were recently treated with a biologic/tsDMARD as part of usual care, was conducted in Q4 2016 among physicians in EU5 countries. Eligible patient charts (≥5) were randomly selected from patients visiting each center/practice during the screening period. In addition to disease characteristics, level of patient involvement in treatment decision making was captured on a 7-point scale, and patients were stratified into low-medium involvement (1-4/7) and high involvement (5-7/7). Descriptive statistics were used to compare both groups.

RESULTS: There were 1277 biologic RA patients: Highly involved: 844 (66%), and Low-mid involved: 433 (34%). Mean age was 51 vs. 54 years; about 48% vs.36% were employed full-time; with average disease duration 79.2 vs.87.3 months among the highly involved vs. low-mid involved patients respectively. Among patients with available lab measures, low-mid involved patients had higher ESR(mm/h) (17.6 vs.19.3); comparable CRP(mg/l) (7.3 vs.7.3); and rheumatoid factor(positive) 82% vs. 81% compared to highly involved patients. Disease severity per physician judgment and disease activity measures in both groups were: mild (62% vs.55%), moderate (30% vs.36%), severe (9% vs. 9%); and mean DAS28 2.8/3.0 in highly involved vs. low-mid involved patients respectively.

CONCLUSIONS: In this cohort of RA patients in the EU5, patients with high involvement were significantly younger, with shorter disease duration and more likely to be employed. These patients were also significantly more likely to have mild disease severity and lower disease activity compared to patients with low involvement.