Achieving clinical remission in rheumatoid arthritis is associated with economic benefits, such as a reduction in both direct and indirect medical costs associated with the disease compared to other activity levels of the chronic disease affecting 23.7 million people worldwide. This is what AbbVie communicates, announcing the publication in ‘Advances in Therapy’ of the results of a new review of the literature on the subject. Rheumatoid arthritis has a significant impact on the daily life of patients: it causes joint pain, swelling, stiffness and loss of function. It generally affects the hands, feet and wrists. In some people it can also cause problems in other parts of the body or more general symptoms such as fatigue. Patients often face periods when symptoms worsen, known as flare-ups, which can be difficult to predict.
“Rheumatoid arthritis – says Silvia Tonolo, president of the National Association of Rheumatic Patients (Anmar) – in addition to generating a considerable physical and emotional burden on people’s lives, is linked to a significant economic impact on the direct and indirect costs of the disease In summary, achieving remission can lead to a significant reduction in costs “.
It has been shown – reads a note from AbbVie – that Achieving remission in rheumatoid arthritis results in savings of between 19% and 52% in direct medical costs (for example, decreasing specialist or outpatient visits, hospitalizations, medical examinations / MRIs / laboratory tests, surgery, physiotherapy, or orthopedic devices) and between 37% and 75% of indirect costs (reducing, for example, the loss of labor productivity and work disability). Patients with persistent disease control also reported fewer disease flare-ups and required fewer disease management resources, such as doctor visits, exams, or physiotherapy than other disease activity levels.
“Achieving high rates of remission from the very beginning of the treatment cycle – explains Roberto Caporali, director of the Department of Rheumatology and Medical Sciences Asst Pini, Cto of Milan – can help patients to maintain joint function and avoid disability. This publication – he stresses – has collected new observations on the economic benefits of achieving remission. These results highlight the importance of the treat-to-target strategy in achieving remission in rheumatoid arthritis “.
Clinical remission in rheumatoid arthritis can be defined as the absence or minimal presence of signs and symptoms of inflammation, including tenderness, joint swelling, and morning stiffness. Clinical remission is commonly assessed using the following indices: Disease activity score (Das28), Simplified disease activity index (Sdai), Clinical disease activity index (Cdai), Boolean criteria. The Das28 is the most commonly used criterion to assess clinical remission in daily practice and in clinical trials. Remission is defined as achieving certain scores using these evaluation criteria (e.g., Das28˂2.6, Sdai≤3.3, Cdai≤2.8).
There is no definitive cure for rheumatoid arthritis but advances over the past 20 years have made it possible for patients to achieve remission, a condition in which the signs and symptoms of the disease, painful and swollen joints and morning stiffness, they are completely absent or rarely occur. This allows patients to carry out daily activities on a regular basis, such as going to work, taking the children to school or going for a walk. Both the European league against rheumatism (Eular) and the American college of rheumatology (Acr) include remission as a therapeutic goal in their treatment guidelines.
