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Navas C, Minton AP, Rodriguez-Leboeuf AM. The Role of Patient-Reported Outcomes to Measure Treatment Satisfaction in Drug Development. THE PATIENT 2024:10.1007/s40271-024-00702-w. [PMID: 38976224 DOI: 10.1007/s40271-024-00702-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 07/09/2024]
Abstract
Treatment satisfaction is a person's rating of his or her treatment experience, including processes and outcomes. It is directly related to treatment adherence, which may be predictive of treatment effectiveness in clinical and real-world research. Consequently, patient-reported outcome (PRO) instruments have been developed to incorporate patient experience throughout various stages of drug development and routine care. PRO instruments enable clinicians and researchers to evaluate and compare treatment satisfaction data in different clinical settings. It is important to select fit-for-purpose PRO instruments that have demonstrated adequate levels of reliability, validity, and sensitivity to change to support their use. Some of these instruments are unidimensional while some are multidimensional; some are generic and can be applied across different therapeutic areas, while others have been developed for use in a specific treatment modality or condition. This article describes the role of treatment satisfaction in drug development as well as regulatory and Health Technology Assessment (HTA) decision making and calls for more widespread use of carefully selected treatment satisfaction PRO instruments in early- and late-phase drug development.
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Sivasegaran S, Hanafi NSH. Perceptions and practices of self-management among adult patients with gout at a primary care clinic: A qualitative study. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2023; 18:72. [PMID: 38213387 PMCID: PMC10781610 DOI: 10.51866/oa.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Introduction Gout is a chronic disease commonly associated with other comorbidities. Patients' perceived quality of life empowers them in managing their health. Self-management is imparted as part of management among patients with chronic disease. This study aimed to explore the perceptions and practices of self-management among patients with gout from different ethnic groups in Malaysia. Methods A qualitative study was conducted among Malay, Chinese and Indian patients with gout via semi-structured in-depth interviews at the primary care clinic of University Malaya Medical Centre in either English or Malay language. All participants had a gout duration of more than 6 months and were either taking urate-lowering drugs or not using them at all. Results A total of 20 participants were successfully recruited for the study. Among the participants, 18 were men, while two were women. Further, nine were Malays; six, Chinese; and four, Indians. The age ranged from 29 to 81 years, while the gout duration ranged from 1 to 30 years. From the interviews, three themes emerged: experiences with gout, types of self-management of gout and factors influencing self-management of gout. Conclusion Diet control is the main self-management practice of patients with gout. Traditional medicine practices include natural methods such as consumption of different types of vegetable juices, pineapple and papaya. Each ethnicity has its own unique beliefs and food cultures. By understanding the self-management practices of patients from diverse ethnic backgrounds, healthcare practitioners can tailor the treatment of gout to individual needs.
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Affiliation(s)
- Suhashini Sivasegaran
- MD, MMed, Klinik Kesihatan Sandakan, K.M 3.2, Jln Utara Beg Berkunci No. 4, Sandakan, Sabah, Malaysia.
| | - Nik Sherina Haidi Hanafi
- MBBS, MFamMed, PhD, Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Piwowar A, CzwojdzińSki E, Marchewka Z, Adamczuk A, Świątoniowska-Lonc N, Jankowska-Polańska B. Compliance and satisfaction with treatment as a success of therapy effectiveness in the group of patients with ischemic heart disease: a cross-sectional study. Int J Occup Med Environ Health 2023; 36:465-476. [PMID: 37737501 PMCID: PMC10691417 DOI: 10.13075/ijomeh.1896.02107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 06/02/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVES Non-adherence and non-compliance to pharmaceutical treatment is one of the most common causes of not effective management of patients suffering from ischemic heart disease (IHD). It is crucial to understand the reasons behind it but studies on this subject performed in the Polish population are still lacking. MATERIAL AND METHODS The 329 patients (160 male and 169 female) diagnosed with IHD who reported for follow-up appointments are examined. The following standardized questionnaires were used: Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) and Adherence to Refills and Medication Scale (ARMS), which evaluates the patient's compliance and adherence level, respectively. RESULTS Patients with IHD showed moderate compliance with pharmacological recommendations and average satisfaction with treatment. Anemia, drugs side effects, and SATMED-Q total score were significant predictors of the overall ARMS score in the univariate analysis, whereas the male gender and satisfaction with treatment improves this results. In multivariate analysis, significant predictors of lower adherence included family history of IHD, anemia and drugs side effects, while higher education and SATMED-Q overall score increased adherence. CONCLUSIONS Treatment satisfaction is a significant predictor of increased overall treatment adherence as well as adherence in terms of drug intake and drug and prescription refills. Raising patient awareness should be an important goal of future educational activities. Int J Occup Med Environ Health. 2023;36(4):465-76.
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Affiliation(s)
- Agnieszka Piwowar
- Wroclaw Medical University, Department of Toxicology, Faculty of Pharmacy, Wrocław, Poland
| | - Eddie CzwojdzińSki
- Wroclaw Medical University, Department of Toxicology, Faculty of Pharmacy, Wrocław, Poland
| | - Zofia Marchewka
- Wroclaw Medical University, Department of Toxicology, Faculty of Pharmacy, Wrocław, Poland
| | - Aleksandra Adamczuk
- Wroclaw Medical University, Students of Faculty of Pharmacy, Department of Toxicology, Wrocław, Poland
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Wang Y, Xu Y, Tan J, Ye J, Cui W, Hou J, Liu P, Li J, Wang S, Zhao Q. Anti-inflammation is an important way that Qingre-Huazhuo-Jiangsuan recipe treats acute gouty arthritis. Front Pharmacol 2023; 14:1268641. [PMID: 37881185 PMCID: PMC10597652 DOI: 10.3389/fphar.2023.1268641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/21/2023] [Indexed: 10/27/2023] Open
Abstract
Background: Acute gouty arthritis (AGA) significantly impairs patients' quality of life. Currently, existing therapeutic agents exhibit definite efficacy but also lead to serious adverse reactions. Therefore, it is essential to develop highly efficient therapeutic agents with minimal adverse reactions, especially within traditional Chinese medicine (TCM). Additionally, food polyphenols have shown potential in treating various inflammatory diseases. The Qingre-Huazhuo-Jiangsuan-Recipe (QHJR), a modification of Si-Miao-San (SMS), has emerged as a TCM remedy for AGA with no reported side effects. Recent research has also highlighted a strong genetic link to gout. Methods: The TCM System Pharmacology (TCMSP) database was used to collect the main chemical components of QHJR and AGA-related targets for predicting the metabolites in QHJR. HPLC-Q-Orbitrap-MS was employed to identify the ingredients of QHJR. The collected metabolites were then used to construct a Drugs-Targets Network in Cytoscape software, ranked based on their "Degree" of significance. Differentially expressed genes (DEGs) were screened in the Gene Expression Omnibus (GEO) database using GEO2R online analysis. Subsequently, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed. The DEGs were utilized to construct a Protein-Protein Interaction (PPI) Network via the STRING database. In vivo experimental validation was conducted using colchicine, QHJR, rapamycin (RAPA), and 3-methyladenine (3-MA) as controls to observe QHJR's efficacy in AGA. Synovial tissues from rats were collected, and qRT-PCR and Western blot assays were employed to investigate Ampk-related factors (Ampk, mTOR, ULK1), autophagy-related factors (Atg5, Atg7, LC3, p62), and inflammatory-related factors (NLRP3). ELISA assays were performed to measure inflammatory-related factor levels (IL-6, IL-1β, TNF-α), and H&E staining was used to examine tissue histology. Results: Network analysis screened out a total of 94 metabolites in QHJR for AGA. HPLC-Q-Orbitrap-MS analysis identified 27 of these metabolites. Notably, five metabolites (Neochlorogenic acid, Caffeic acid, Berberine, Isoliquiritigenin, Formononetin) were not associated with any individual herbal component of QHJR in TCMSP database, while six metabolites (quercetin, luteolin, formononetin, naringenin, taxifolin, diosgenin) overlapped with the predicted results from the previous network analysis. Further network analysis highlighted key components, such as Caffeic acid, cis-resveratrol, Apigenin, and Isoliquiritigenin. Other studies have found that their treatment of AGA is achieved through reducing inflammation, consistent with this study, laying the foundation for the mechanism study of QHJR against AGA. PPI analysis identified TNF, IL-6, and IL-1β as hub genes. GO and KEGG analyses indicated that anti-inflammation was a key mechanism in AGA treatment. All methods demonstrated that inflammatory expression increased in the Model group but was reversed by QHJR. Additionally, autophagy-related expression increased following QHJR treatment. The study suggested that AMPKα and p-AMPKα1 proteins were insensitive to 3 MA and RAPA, implying that AMPK may not activate autophagy directly but through ULK1 and mTOR. Conclusion: In conclusion, this study confirms the effectiveness of QHJR, a modified formulation of SMS (a classic traditional Chinese medicine prescription for treating gout), against AGA. QHJR, as a TCM formula, offers advantages such as minimal safety concerns and potential long-term use. The study suggests that the mechanism by which QHJR treats AGA may involve the activation of the AMPK/mTOR/ULK1 pathway, thereby regulating autophagy levels, reducing inflammation, and alleviating AGA. These findings provide new therapeutic approaches and ideas for the clinical treatment of AGA.
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Affiliation(s)
- Yazhuo Wang
- Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yang Xu
- Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jingrui Tan
- Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jiaxue Ye
- Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Weizhen Cui
- Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jie Hou
- Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Peiyu Liu
- Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jianwei Li
- Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shiyuan Wang
- Institute of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qingyang Zhao
- Institute of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, China
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Watson L, Belcher J, Nicholls E, Chandratre P, Blagojevic-Bucknall M, Hider S, Lawton SA, Mallen CD, Muller S, Rome K, Roddy E. Factors associated with change in health-related quality of life in people with gout: a 3-year prospective cohort study in primary care. Rheumatology (Oxford) 2023; 62:2748-2756. [PMID: 36545704 PMCID: PMC10393433 DOI: 10.1093/rheumatology/keac706] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/02/2022] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVE To describe factors associated with change in health-related quality of life (HRQOL) in people living with gout in primary care. METHODS In a UK prospective cohort study, adults with a diagnosis of gout registered with 20 general practices completed the Gout Impact Scale (GIS; scale 0-100), 36-item Short Form Physical Function subscale (PF-10; 0-100) and HAQ Disability Index (HAQ-DI; 0-3) via postal questionnaires at baseline and 6, 12, 24 and 36 months. Linear mixed modelling was used to investigate factors associated with changes in HRQOL over 3 years. RESULTS A total of 1184 participants responded at baseline (adjusted response 65.6%); 990 (83.6%) were male, with a mean age of 65.6 years (s.d. 12.5). A total of 818, 721, 696 and 605 responded at 6, 12, 24 and 36 months, respectively. Factors associated with worse disease-specific and generic HRQOL over 3 years were flare frequency (five or more flares; GIS subscales, PF-10), oligo/polyarticular flares (GIS subscales, PF-10, HAQ-DI), worse pain (GIS subscales, PF-10, HAQ-DI), body pain (GIS subscales, PF-10, HAQ-DI) and more severe depression (GIS subscales, PF-10, HAQ-DI) (P ≤ 0.05). More severe anxiety was associated with worse disease-specific HRQOL only (GIS subscales). Older age (PF-10), being female (PF-10, HAQ-DI) and BMI (HAQ-DI) were associated with worse generic HRQOL (P ≤ 0.05). CONCLUSION Gout-specific, comorbid and sociodemographic factors were associated with change in HRQOL over a 3-year period, highlighting people at risk of worse outcomes who could be targeted for interventions.
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Affiliation(s)
| | | | - Elaine Nicholls
- School of Medicine, Keele University, Keele, UK
- Keele Clinical Trials Unit, Keele University, Keele, UK
| | - Priyanka Chandratre
- Department of Rheumatology, Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
| | | | - Samantha Hider
- School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, UK
| | | | - Christian D Mallen
- School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, UK
| | - Sara Muller
- School of Medicine, Keele University, Keele, UK
| | - Keith Rome
- School of Clinical Sciences, AUT University, Auckland, New Zealand
| | - Edward Roddy
- School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, UK
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Abu Hamdeh H, Al-Jabi SW, Koni A, Zyoud SH. Health-related quality of life and treatment satisfaction in Palestinians with rheumatoid arthritis: a cross-sectional study. BMC Rheumatol 2022; 6:19. [PMID: 35382894 PMCID: PMC8985358 DOI: 10.1186/s41927-022-00251-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/10/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Studying health-related quality of life (HRQoL) and treatment satisfaction have helped in understanding how to optimize rheumatoid arthritis (RA) treatment outcomes and find ways to alleviate signs and symptoms among patients. OBJECTIVE In this study, our objective was to evaluate the association between satisfaction with care and HRQoL among RA patients from northern Palestine. In addition, this study also aimed to determine the associations between the clinical characteristics of patients with RA with treatment satisfaction and HRQoL. METHODS This was a multicenter cross-sectional study conducted between July and October 2018. Patients with RA diagnosis who presented at rheumatology clinics were interviewed. The SF-36 short questionnaire was used to assess HRQoL and Treatment Satisfaction Questionnaire for Medication (TSQM) version 1.4 to assess treatment satisfaction among study groups. We use descriptive and comparative statistics to present the results. RESULTS A total of 283 patients were included. Several sociodemographic and clinical characteristics were found to be associated with poor HRQoL scores and low treatment satisfaction. The physical component summary (PCS) was negatively associated with age, patients' self-reported disease activity, duration of the disease, and the total number of medications taken by the patient, and was positively associated with educational background, employment, and household income. The mental component summary (MCS) was negatively associated with patients' self-reported disease activity and the patient's total number of comorbid diseases. The number of comorbid diseases was negatively associated with effectiveness. All HRQoL subscales were significantly correlated with treatment satisfaction. The range of correlation with PCS was between 0.272 for convenience and 0.425 for side effects (p < 0.001). Similarly, the highest correlation with MCS was 0.458 for side effects, and the lowest was 0.337 for convenience (p < 0.001). CONCLUSIONS The current study found that HRQoL was significantly correlated with treatment satisfaction. Furthermore, the results of this study showed that HRQoL and treatment satisfaction are likely to be affected by sociodemographic and clinical characteristics. These results may be beneficial in clinical practice, mainly in the early treatment of patients with RA, at a stage where it is still possible to increase treatment satisfaction.
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Affiliation(s)
- Heba Abu Hamdeh
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Samah W. Al-Jabi
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Amer Koni
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Division of Clinical Pharmacy, Hematology and Oncology Department, An-Najah National University Hospital, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Clinical Research Centre, An-Najah National University Hospital, Nablus, 44839 Palestine
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Sansone A, Reisman Y, Jannini EA. Relationship between hyperuricemia with deposition and sexual dysfunction in males and females. J Endocrinol Invest 2022; 45:691-703. [PMID: 34997558 PMCID: PMC8741558 DOI: 10.1007/s40618-021-01719-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/01/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE The association between gout, the most common crystal arthropathy, and sexual dysfunctions has often been investigated by studies in the last decades. Despite the presence of shared risk factors and comorbidities and the possible effects on sexual health of long-term gout complications, awareness of this association is severely lacking and the pathogenetic mechanisms have only partially been identified. In the present review, we aimed to investigate the current evidence regarding the potential mechanisms linking sexual dysfunctions and gout. METHODS A comprehensive literature search within PubMed was performed to provide a summary of currently available evidence regarding the association between gout and sexual dysfunctions. RESULTS Gout and sexual dysfunctions share several risk factors, including diabesity, chronic kidney disease, hypertension, metabolic syndrome, and peripheral vascular disease. Gout flares triggered by intense inflammatory responses feature severe pain and disability, resulting in worse sexual function, and some, but not all, treatments can also impair sexual health. Long-term gout complications can result in persistent pain and disability due to joint deformity, fractures, or nerve compression, with negative bearing on sexual function. The presence of low-grade inflammation impairs both sex steroids synthesis and endothelial function, further advancing sexual dysfunctions. The psychological burden of gout is another issue negatively affecting sexual health. CONCLUSIONS According to currently available evidence, several biological and psychological mechanisms link sexual dysfunctions and gout. Addressing risk factors and providing adequate treatment could potentially have beneficial effects on both conditions. Appropriate clinical evaluation and multidisciplinary approach are recommended to improve patient care.
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Affiliation(s)
- A Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy
| | - Y Reisman
- Flare-Health, Amstelveen, The Netherlands
| | - E A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
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Zhou M, Hua L, Wang YF, Chen ST, Yang CM, Zhang M, Li X, Li B. Oral Huzhang granules for the treatment of acute gouty arthritis: protocol for a double-blind, randomized, controlled trial. Trials 2022; 23:248. [PMID: 35365187 PMCID: PMC8973546 DOI: 10.1186/s13063-022-06188-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background Acute gouty arthritis (GA) is the main clinical manifestation and the most common initial symptom of gout. The treatment of acute GA involves the use of colchicine, non-steroidal anti-inflammatory drugs, and corticosteroids. Because of the side effects of these drugs, their clinical applications are limited. The use of traditional Chinese medicine for the treatment of acute GA has unique advantages. The aim of this trial is to clarify the treatment efficacy, safety, and recurrence control efficacy of Huzhang granules (HZG) in patients with GA showing dampness-heat syndrome. Methods/design This double-blind, randomized, controlled trial was planned to be conducted between July 1, 2020, and December 31, 2022. A sample size of 267 participants (89 per group) with GA will be randomly assigned to three treatment groups in the ratio of 1:1:1: HZG, etoricoxib, and placebo groups. The study duration is 13 days, including a 1-day screening period, 5-day intervention period, and 1-week follow-up period. The primary outcome is analgesic effectiveness, assessed as pain in the worst-affected joint, which will be measured using the visual analog scale. Secondary outcomes include the patient’s assessment of pain in the primary study joint, patient’s global assessment of response to therapy, investigator’s global assessment of response to therapy, investigator’s assessment of tenderness and swelling of the study joint, and TCM syndromes. Furthermore, the number, nature, and severity of adverse events will be recorded. Discussion This study will provide evidence regarding the clinical efficacy and safety of Chinese medicine treatment for acute gouty arthritis. This study will provide noteworthy findings. Trial registration ClinicalTrials.gov NCT04462666. Registered on July 05, 2020 (first version).
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Affiliation(s)
- Mi Zhou
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
| | - Liang Hua
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
| | - Yi-Fei Wang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China.,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Si-Ting Chen
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China.,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Chun-Mei Yang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China.,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Ming Zhang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China. .,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Bin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China. .,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China.
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lv L, Qin T, Huang Q, Jiang H, Chen F, Long F, Ren L, Liu J, Xie Y, Zeng M. Targeting Tristetraprolin Expression or Functional Activity Regulates Inflammatory Response Induced by MSU Crystals. Front Immunol 2021; 12:675534. [PMID: 34335573 PMCID: PMC8322984 DOI: 10.3389/fimmu.2021.675534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/21/2021] [Indexed: 12/13/2022] Open
Abstract
The RNA-binding protein tristetraprolin (TTP) is an anti-inflammatory factor that prompts the mRNA decay of target mRNAs and is involved in inflammatory diseases such as rheumatoid arthritis (RA). TTP is regulated by phosphorylation, and protein phosphatase 2A (PP2A) can dephosphorylate TTP to activate its mRNA-degrading function. Some small molecules can enhance PP2A activation. Short interfering RNA (siRNA) targeting TTP expression or PP2A agonist (Arctigenin) was administered to monosodium urate (MSU) crystal-induced J774A.1 cells, and the expression of inflammatory related genes was detected by RT-PCR and Western blot assays. The effects of Arctigenin in mouse models of acute inflammation induced by MSU crystals, including peritonitis and arthritis, were evaluated. The data indicated that TTP expression levels and endogenous PP2A activity were increased in MSU-crystal treated J774A.1 cells. TTP knockdown exacerbated inflammation-related genes expression and NLRP3 inflammasome activation. However, PP2A agonist treatment (Arctigenin) suppressed MSU crystal-induced inflammation in J774A.1 cells. Arctigenin also relieved mitochondrial reactive oxygen species (mtROS) production and improved lysosomal membrane permeability in MSU crystal-treated J774A.1 cells. Moreover, TTP knockdown reversed the anti-inflammatory and antioxidant effects of Arctigenin. Oral administration of Arctigenin significantly alleviated foot pad swelling, the number of inflammatory cells in peritoneal lavage fluids and the production of IL-1β in the mouse model of inflammation induced by MSU crystals. Collectively, these data imply that targeting TTP expression or functional activity may provide a potential therapeutic strategy for inflammation caused by MSU crystals.
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Affiliation(s)
- Linxi lv
- Institute of Rheumatology and Immunology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Biology Group of Preclinical School of North SiChuan Medical College, Nanchong, China
| | - Ting Qin
- Institute of Rheumatology and Immunology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Qiushi Huang
- Institute of Rheumatology and Immunology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Biology Group of Preclinical School of North SiChuan Medical College, Nanchong, China
| | - Hui Jiang
- Institute of Rheumatology and Immunology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Biology Group of Preclinical School of North SiChuan Medical College, Nanchong, China
| | - Feng Chen
- Institute of Rheumatology and Immunology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Biology Group of Preclinical School of North SiChuan Medical College, Nanchong, China
| | - Fan Long
- Clinical Lab of The Fifth People’s Hospital of Nanchong City, Nanchong, China
| | - Long Ren
- Clinical Lab of The Fifth People’s Hospital of Nanchong City, Nanchong, China
| | - Jianpin Liu
- Institute of Rheumatology and Immunology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yongen Xie
- Biology Group of Preclinical School of North SiChuan Medical College, Nanchong, China
| | - Mei Zeng
- Institute of Rheumatology and Immunology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Biology Group of Preclinical School of North SiChuan Medical College, Nanchong, China
- Clinical Lab of The Fifth People’s Hospital of Nanchong City, Nanchong, China
- Medical Imaging Key Laboratory of Sichuan, North SiChuan Medical College, Nanchong, China
- Academician (Expert) Workstation, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Te Kampe R, Jansen TL, van Durme C, Janssen M, Petersen G, Boonen A. Outcomes of Care Among Patients With Gout in Europe: A Cross-sectional Survey. J Rheumatol 2021; 49:312-319. [PMID: 34329184 DOI: 10.3899/jrheum.210009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess health- and patient-centered outcomes in gout across Europe, and explore patient-, care-, and country-level characteristics associated with these outcomes. METHODS Patients with self-reported physician-diagnosed gout from 14 European countries completed an online survey. Multivariable mixed-effect logistic and linear regressions were computed for health outcomes (gout flare recurrence) and patient-centered outcomes (patient satisfaction with current medication, and unaddressed goals), accounting for clustering within countries. The role of patient-, care-, and country-level factors was explored. RESULTS Participants included 1029 patients, predominantly diagnosed by a general practitioner (GP). One or more gout flares were reported by 70% of patients and ≥ 3 flares by 32%. Gout patients reported 1.1 ± 1.2 unaddressed goals, and 80% were satisfied with current medication. Patients with ≥ 3 and ≥ 1 flares were less likely to be treated with urate-lowering therapy (ULT) (OR 0.52, 95% CI 0.39-0.70 and OR 0.38, 95% CI 0.28-0.53, respectively), but more likely to have regular physician visits (OR 2.40, 95% CI 1.79-3.22 and OR 1.77, 95% CI 1.30-2.41). Three or more gout flares were also associated with lower satisfaction (OR 0.39, 95% CI 0.28-0.56) and more unaddressed goals (β 0.36, 95% CI 0.19-0.53). Notwithstanding, the predicted probability of being satisfied was still between 57% and 75% among patients with ≥ 3 flares but who were not receiving ULT. Finally, patients from wealthier and Northern European countries more frequently had ≥ 3 gout flares. CONCLUSION Across Europe, many patients with gout remain untreated despite frequent reported flares. Remarkably, a substantial proportion of them were still satisfied with gout management. A better understanding of patients' satisfaction and its role in physicians' gout management decisions is warranted to improve quality of care and gout outcomes across Europe.
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Affiliation(s)
- Ritch Te Kampe
- The data collection for this study was funded by Grünenthal GmbH. R. te Kampe, MSc, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, and Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; T.L. Jansen, MD, PhD, M. Janssen, MD, PhD, Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; C. van Durme, MD, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands, and Centre Hospitalier Chrétien, Liège, Belgium; G. Petersen, PhD, Grünenthal GmbH, Aachen, Germany; A. Boonen, Professor, MD, PhD, Department of Internal Medicine, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. GP is a full-time employee in the department of Governmental Affairs & Patient Centricity at Grünenthal GmbH. Address correspondence to R. te Kampe, Department of Rheumatology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. . Accepted for publication May 28, 2021
| | - Tim L Jansen
- The data collection for this study was funded by Grünenthal GmbH. R. te Kampe, MSc, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, and Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; T.L. Jansen, MD, PhD, M. Janssen, MD, PhD, Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; C. van Durme, MD, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands, and Centre Hospitalier Chrétien, Liège, Belgium; G. Petersen, PhD, Grünenthal GmbH, Aachen, Germany; A. Boonen, Professor, MD, PhD, Department of Internal Medicine, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. GP is a full-time employee in the department of Governmental Affairs & Patient Centricity at Grünenthal GmbH. Address correspondence to R. te Kampe, Department of Rheumatology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. . Accepted for publication May 28, 2021
| | - Caroline van Durme
- The data collection for this study was funded by Grünenthal GmbH. R. te Kampe, MSc, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, and Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; T.L. Jansen, MD, PhD, M. Janssen, MD, PhD, Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; C. van Durme, MD, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands, and Centre Hospitalier Chrétien, Liège, Belgium; G. Petersen, PhD, Grünenthal GmbH, Aachen, Germany; A. Boonen, Professor, MD, PhD, Department of Internal Medicine, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. GP is a full-time employee in the department of Governmental Affairs & Patient Centricity at Grünenthal GmbH. Address correspondence to R. te Kampe, Department of Rheumatology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. . Accepted for publication May 28, 2021
| | - Matthijs Janssen
- The data collection for this study was funded by Grünenthal GmbH. R. te Kampe, MSc, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, and Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; T.L. Jansen, MD, PhD, M. Janssen, MD, PhD, Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; C. van Durme, MD, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands, and Centre Hospitalier Chrétien, Liège, Belgium; G. Petersen, PhD, Grünenthal GmbH, Aachen, Germany; A. Boonen, Professor, MD, PhD, Department of Internal Medicine, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. GP is a full-time employee in the department of Governmental Affairs & Patient Centricity at Grünenthal GmbH. Address correspondence to R. te Kampe, Department of Rheumatology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. . Accepted for publication May 28, 2021
| | - Gudula Petersen
- The data collection for this study was funded by Grünenthal GmbH. R. te Kampe, MSc, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, and Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; T.L. Jansen, MD, PhD, M. Janssen, MD, PhD, Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; C. van Durme, MD, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands, and Centre Hospitalier Chrétien, Liège, Belgium; G. Petersen, PhD, Grünenthal GmbH, Aachen, Germany; A. Boonen, Professor, MD, PhD, Department of Internal Medicine, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. GP is a full-time employee in the department of Governmental Affairs & Patient Centricity at Grünenthal GmbH. Address correspondence to R. te Kampe, Department of Rheumatology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. . Accepted for publication May 28, 2021
| | - Annelies Boonen
- The data collection for this study was funded by Grünenthal GmbH. R. te Kampe, MSc, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, and Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; T.L. Jansen, MD, PhD, M. Janssen, MD, PhD, Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; C. van Durme, MD, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands, and Centre Hospitalier Chrétien, Liège, Belgium; G. Petersen, PhD, Grünenthal GmbH, Aachen, Germany; A. Boonen, Professor, MD, PhD, Department of Internal Medicine, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. GP is a full-time employee in the department of Governmental Affairs & Patient Centricity at Grünenthal GmbH. Address correspondence to R. te Kampe, Department of Rheumatology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. . Accepted for publication May 28, 2021
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Yang P, Chen Z, Chen YT, Liu M, Zhang M, Yang X, Lin C, Xu Q. Use of the Gout Impact Scale to Evaluate Quality of Life in Chinese Subjects with Gout: A Cross-Sectional Study. Med Sci Monit 2020; 26:e925593. [PMID: 32991572 PMCID: PMC7532695 DOI: 10.12659/msm.925593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/26/2020] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND To use a gout-specific quality of life (QoL) tool, the Gout Impact Scale (GIS), to evaluate characteristics of gout affecting QoL in subjects with gout. MATERIAL AND METHODS In this cross-sectional study, 169 individuals with gout completed the 24-item GIS and a general questionnaire regarding gout characteristics. The reliability and validity of the GIS were verified by Cronbach's a and exploratory factor analysis, respectively. The impact of gout characteristics on the QoL of subjects with gout was assessed by stepwise multiple regression analysis. RESULTS The 169 subjects with gout included 149 (88.2%) men and 20 (11.8%) women, of median age 43 years. The reliability of the GIS was appropriate (0.84-0.90), except for Gout Medication Side Effects (0.69) and Unmet Gout Treatment Need (0.59). Exploratory factor analysis showed that construct validity was acceptable, with a cumulative variance contribution rate of 5 common factors of 70.09% and factor loading >0.5 between each pair of items of the GIS. Univariate analysis showed that male sex was positively correlated with Well-being During Attack (p<0.05), and that source of medical expenses, current cigarette use and drinking were significantly correlated with Unmet Gout Treatment Need (p<0.05 each). A family history of gout, gout flares, and attack frequency were significantly correlated with total GIS, Well-being During Attack, and Gout Concern during Attack (p<0.05 each). Multivariate analysis suggested that history of gouty arthritis, acute attack and attack frequency had a considerable impact on QoL (p<0.05 each). CONCLUSIONS The GIS showed acceptable reliability and validity in identifying associations between poor QoL and gout characteristics.
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Affiliation(s)
- Peidan Yang
- Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Zhixin Chen
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
- Chinese Medicine Department, South China Agricultural University Hospital, Guangzhou, Guangdong, P.R. China
| | - Yimin Talia Chen
- Department of Microbiology, University of Rochester, Rochester, NY, U.S.A
| | - Minying Liu
- Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Mingying Zhang
- Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Xiangwei Yang
- Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Changsong Lin
- Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Qiang Xu
- Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
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Understanding the patient voice in gout: a quantitative study conducted in Europe. BJGP Open 2020; 4:bjgpopen20X101003. [PMID: 32071040 PMCID: PMC7330181 DOI: 10.3399/bjgpopen20x101003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 09/10/2019] [Indexed: 12/27/2022] Open
Abstract
Background Although commonly diagnosed, gout often remains a poorly managed disease. This is partially due to a lack of awareness of the long-term effect of gout among patients and healthcare professionals. Aim To understand unmet needs for patients and provide insight into achieving better treatment. Design & setting A quantitative online questionnaire collected from 1100 people with gout from 14 countries within Europe. Method Patients were recruited to complete an online survey via healthcare professional (HCP) referral, patient associations, or market research panels. Patients were included if they had been diagnosed with gout by a physician. Prior to commencement, patients were made aware that this study was sponsored by Grünenthal. The responses collected were collated and analyses were performed. Results Patients had an average of 2.9 gout flares within a 12-month period. Although 79% of patients were satisfied with treatment, inadequate gout control was also reported by 71% of patients. Furthermore, 84% experienced moderate-to-severe pain with their most recent flare. Of those who acknowledged treatment dissatisfaction, only 24% discussed other options with their GP. Most patients reported irregular follow-up and serum uric acid (sUA) monitoring. In addition, loss of belief that more can be done was a key barrier for patients. Conclusion Patients reported severe pain and social burden, coupled with low treatment expectation and lack of awareness of target sUA. Education around knowing and reaching sUA target is needed so that patients can receive and GPs can deliver higher quality management.
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Jiang N, Yang P, Liu S, Li H, Wu L, Shi X, Fang Y, Zhao Y, Xu J, Jiang Z, Wu Z, Duan X, Wang Q, Tian X, Li M, Zeng X. Satisfaction of Patients and Physicians with Treatments for Rheumatoid Arthritis: A Population-Based Survey in China. Patient Prefer Adherence 2020; 14:1037-1047. [PMID: 32606620 PMCID: PMC7320887 DOI: 10.2147/ppa.s232578] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 03/14/2020] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Rheumatoid arthritis (RA) is a systemic inflammatory disease characterized by chronic destructive synovitis and possible multisystem involvement. This study aimed to survey the treatment satisfaction of physicians and patients with RA, and to explore the potential factors. PATIENTS AND METHODS This cross-sectional study was conducted in 12 centers across China between March 2018 and April 2018. The Treatment Satisfaction Questionnaire for Medication version II was used to assess the treatment satisfaction of patients and physicians. Multivariable regression analysis was used to determine the factors independently associated with treatment satisfaction of patients. RESULTS The patients' satisfaction (n=335) with biological disease-modifying antirheumatic drugs (bDMARDs) was higher than physicians' satisfaction (n=146) regarding the side effects (95.0±14.3 vs 84.6±15.7, P<0.001) and convenience (74.6±21.2 vs 69.1±16.5, P=0.002). Among physicians, global satisfaction with bDMARDs was higher than that with conventional synthetic DMARDs (csDMARDs). The multivariable regression analysis showed that age was positively associated with satisfaction of patients, while college or above education and self-assessment of disease severity were inversely associated with satisfaction. Treatment satisfaction was associated positively with the quality of communication with the physician and inversely with treatment costs. CONCLUSION For bDMARDs, the treatment satisfaction of patients with RA is generally higher than that of physicians'. Physicians' satisfaction with bDMARDs is higher than with csDMARDs. Age, education, disease severity, communication with the physician, and treatment costs are independently associated with the treatment satisfaction among patients. Physician-patient communication should be improved in clinical practice. Treatment costs should be taken into account when physicians make decisions.
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Affiliation(s)
- Nan Jiang
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
| | - Pingting Yang
- Department of Rheumatology and Immunology, First Affiliated Hospital, China Medical University, Shenyang, People’s Republic of China
| | - Shengyun Liu
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Hongbin Li
- Department of Rheumatology, Affiliated Hospital of Inner Mongolia Medical College, Hohhot, Inner Mongolia, People’s Republic of China
| | - Lijun Wu
- Department of Rheumatology and Immunology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, People’s Republic of China
| | - Xiaofei Shi
- Department of Rheumatology and Immunology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan, People’s Republic of China
| | - Yongfei Fang
- Department of Rheumatology, Southwest Hospital, Third Military Medical University, Chongqing, People’s Republic of China
| | - Yi Zhao
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jian Xu
- Department of Rheumatology and Immunology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of China
| | - Zhenyu Jiang
- Department of Rheumatology, The First Hospital of Jilin University, Changchun, Jilin, People’s Republic of China
| | - Zhenbiao Wu
- Department of Clinical Immunology and Rheumatology, Xijing Hospital Affiliated to the Fourth Military Medical University, Shanxi, People’s Republic of China
| | - Xinwang Duan
- Department of Rheumatology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
| | - Qian Wang
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
| | - Xinping Tian
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
| | - Mengtao Li
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
| | - Xiaofeng Zeng
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Correspondence: Xiaofeng Zeng; Mengtao Li Department of Rheumatology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing Ave, Beijing100730, People’s Republic of China Tel/Fax + 86-10-69158793 Email ;
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Schriefer D, Haase R, Kullmann JS, Ziemssen T. Health-Related Quality of Life and the Relationship to Treatment Satisfaction in Patients with Multiple Sclerosis: Insights from a Large Observational Study. Patient Prefer Adherence 2020; 14:869-880. [PMID: 32546981 PMCID: PMC7250312 DOI: 10.2147/ppa.s248272] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/05/2020] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION In patients with multiple sclerosis (MS), fatigue, depression, and physical disability are important determinants that negatively affect health-related quality of life (HRQoL). In studies about MS, HRQoL and treatment satisfaction are emerging endpoints representing the patients' perspective. However, the association of HRQoL and MS treatment satisfaction has not been evaluated so far. PURPOSE Our objective was to evaluate the relationship of different dimensions of HRQoL and treatment satisfaction (effectiveness, side effects, convenience), and to assess which factors of treatment satisfaction, besides disease-related and sociodemographic explanatory factors, can best describe HRQoL. PATIENTS AND METHODS We analyzed data from a cross-sectional, observational multicenter study in Germany (THEPA-MS, N=2990 eligible patients for first-line treatment). The instruments used were the SF-36 for HRQoL and the TSQM for treatment satisfaction. Correlation analyses, classification and regression trees and multivariate linear regression with the least absolute shrinkage and selection operator (LASSO) for global variable selection were used to analyze explanatory factors of HRQoL. RESULTS The SF-36 physical summary score was 45.49 ±12.03 and mental component summary score 42.87 ±12.12, with currently untreated patients (N=250) reporting lower HRQoL than patients under first-line treatment (N=2740) (p<0.001). Physical disability (standardized beta (b)=0.408) was the strongest cross-sectional predictor for physical health, followed by employment status (b=0.163), age (b=0.159) and treatment satisfaction in terms of side effects (b=0.146) and effectiveness (b=0.137). For the mental summary health dimension, presence of a major depressive episode (b=0.234) had the greatest impact, followed by satisfaction with side effects (b=0.152) and effectiveness (b=0.131). CONCLUSION Satisfaction with the effectiveness and side effects of treatment was part of the main independent explanatory variables for mental and physical HRQoL in patients with MS. To improve HRQoL, patients' needs and satisfaction measures may be integral part of disease management beyond treatment of physical disability, depression or fatigue.
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Affiliation(s)
- Dirk Schriefer
- University Clinic Carl Gustav Carus Dresden, Center of Clinical Neuroscience, Dresden, Germany
| | - Rocco Haase
- University Clinic Carl Gustav Carus Dresden, Center of Clinical Neuroscience, Dresden, Germany
| | | | - Tjalf Ziemssen
- University Clinic Carl Gustav Carus Dresden, Center of Clinical Neuroscience, Dresden, Germany
- Correspondence: Tjalf Ziemssen Tel +49-351-458-4465Fax +49-351-458-5717 Email
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Noël E, Dussol B, Lacombe D, Bedreddine N, Fouilhoux A, Ronco P, Genevaz D, Bekri S, Hagège A, Dupuis-Siméon F, Derrien Ansquer V, Germain DP, Lidove O. Treatment needs and expectations for Fabry disease in France: development of a new Patient Needs Questionnaire. Orphanet J Rare Dis 2019; 14:284. [PMID: 31801581 PMCID: PMC6894302 DOI: 10.1186/s13023-019-1254-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 11/07/2019] [Indexed: 02/05/2023] Open
Abstract
Background Fabry disease (FD) is a rare, X-linked, inherited lysosomal disease caused by absent or reduced α-galactosidase A activity. Due to the heterogeneity of disease presentation and progression, generic patient-reported outcome (PRO) tools do not provide accurate insight into patients’ daily lives and impact of disease specific treatments. Also, the French National Health Authority, (HAS) actively encourages a patient-centric approach to improve the quality of care throughout the patient journey. In response to this initiative, we aimed to develop and validate a specific, self-reported, Patient Needs Questionnaire for people living with Fabry disease to appraise patient needs and expectations towards their treatment (PNQ Fabry). This endeavour was led with the help of French patient associations (APMF & VML) and dedicated expert centres. PNQ Fabry was developed according to the FDA/EMA methodologies and best practices for the development of PRO tools in rare diseases. Our approach comprised of three steps, as follows: concept elicitation and item generation, item reduction, and final validation of the questionnaire through a two-stage survey. Results Intrinsic and extrinsic reliability was established, using a validated benchmark questionnaire. With the invaluable help of patient associations, we recruited a satisfactory population in this rare disease setting, to ensure robust participation to validate our PNQ (final number of questionnaires: 76). At the end of the process, a 26-item patient-reported questionnaire was obtained with excellent psychometric properties, exhibiting very satisfactory measurement outcomes for reliability and validity. The results of this initiative demonstrate that the PNQ Fabry is accurate, suitable and tailored to FD patients, as it addresses themes identified during patient interviews, that were further validated through statistical analyses of quantitative surveys. An ongoing phase IV study is using this tool. Conclusion We believe the PNQ Fabry will be a reliable and insightful tool in clinical practice, to improve patient management in FD.
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Affiliation(s)
- Esther Noël
- Strasbourg University Hospital, Strasbourg, France.
| | | | - Didier Lacombe
- Bordeaux University Hospital, INSERM U1211, Bordeaux University, Bordeaux, France
| | - Najya Bedreddine
- Association des Patients de la Maladie de Fabry (APMF), Marsannay la Côte, France
| | - Alain Fouilhoux
- Lyon University Hospital - Lyon Civil Hospital, Lyon, France
| | | | | | | | | | | | | | - Dominique P Germain
- French Referral Center for Fabry disease, Division of Medical Genetics and INSERM U1179, University of Versailles, Paris-Saclay University, Montigny, France
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Kimman ML, Wijsenbeek MS, van Kuijk SMJ, Wijnsma KL, van de Kar NCAJ, Storm M, van Jaarsveld X, Dirksen CD. Validity of the Patient Experiences and Satisfaction with Medications (PESaM) Questionnaire. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2019; 12:149-162. [PMID: 30367435 PMCID: PMC6335379 DOI: 10.1007/s40271-018-0340-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background This study assessed the validity and reliability of the generic module of the recently developed Patient Experiences and Satisfaction with Medications (PESaM) questionnaire in a sample of patients in the Netherlands. Methods The generic module of the PESaM questionnaire consists of 18 items related to the domains effectiveness, side effects and ease of use of medications. It assesses patients’ experiences regarding the impact of the medication on daily life, health and satisfaction. In 2017, the PESaM questionnaire was sent out to idiopathic pulmonary fibrosis patients using pirfenidone or nintedanib, atypical haemolytic uraemic syndrome patients receiving eculizumab and patients using tacrolimus after kidney transplantation. Mean scores for each domain were calculated applying a scoring algorithm. Construct validity and reliability were assessed using recommended methods. Results 188 participants completed the generic module, of whom 48% used pirfenidone, 36% nintedanib, 11% tacrolimus and 5% eculizumab. The generic module has good structural properties. Internal consistency values of the domains were satisfactory (i.e. Cronbach’s coefficient alpha above 0.7). Confirmatory factor analysis provided further evidence for construct validity, with good convergent and discriminant validity. The PESaM questionnaire also showed different scores for patients using different medications, in line with expectations, and was therefore able to differentiate between patient groups. Test–retest reliability of the items and domains were rated as moderate to fair (i.e. intraclass coefficients ranged between 0.18 and 0.76). Conclusions The PESaM questionnaire is a unique patient-reported outcome measure evaluating patient experiences and satisfaction with medications. It has been developed in conjunction with patients, ensuring coverage of domains and issues relevant from the patient’s perspective. This study has shown promising validity of the generic module of the PESaM questionnaire. Further research is recommended to assess reliability in greater detail as well as the responsiveness of the measure. Trial registration The study is registered in The Netherlands National Trial Register (Trial Code 5860).
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Affiliation(s)
- Merel L. Kimman
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marlies S. Wijsenbeek
- Department of Respiratory Medicine, Erasmus Medical Centre, University Hospital Rotterdam, Rotterdam, The Netherlands
| | - Sander M. J. van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kioa L. Wijnsma
- Department of Pediatric Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Amalia Children’s Hospital, Nijmegen, The Netherlands
| | - Nicole C. A. J. van de Kar
- Department of Pediatric Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Amalia Children’s Hospital, Nijmegen, The Netherlands
| | | | | | - Carmen D. Dirksen
- Department of Clinical Epidemiology and Medical Technology Assessment, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
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Abstract
Psoriatic arthritis (PsA) is a multifaceted disease, with a high impact on patients’ psychological and physical well-being. There is increasing recognition that assessment of both clinical aspects of disease and patient identified concerns, such as fatigue, work disability, and treatment satisfaction need to be addressed. Only then can we fully understand disease burden and make well-informed treatment decisions aimed at improving patients’ lives. In recent years, there has been much progress in the development of unidimensional and composite measures of disease activity, as well as questionnaires capturing the patient’s perspective in psoriatic disease. Despite these advances, there remains disagreement amongst clinicians as to which instruments should be used. As a consequence, they are yet to receive widespread implementation in routine clinical practice. This review aims to summarize currently available clinical and patient-derived assessment tools, which will provide clinicians with a practical and informative resource.
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18
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Abstract
Acute gout arthritis flares contribute dominantly to gout-specific impaired health-related quality of life, representing a progressively increasing public health problem. Flares can be complex and expensive to treat, partly due to the frequent comorbidities. Unmet needs in gout management are more pressing given the markedly increasing gout flare hospital admission rates. In addition, chronic gouty arthritis can cause joint damage and functional impairment. This review addresses new knowledge on the basis for the marked, inherent variability of responses to deposited urate crystals, including the unpredictable and self-limited aspects of many gout flares. Specific topics reviewed include how innate immunity and two-signal inflammasome activation intersect with diet, metabolism, nutritional biosensing, the microbiome, and the phagocyte cytoskeleton and cell fate. The paper discusses the roles of endogenous constitutive regulators of inflammation, including certain nutritional biosensors, and emerging genetic and epigenetic factors. Recent advances in the basis of variability in responses to urate crystals in gout provide information about inflammatory arthritis, and have identified potential new targets and strategies for anti-inflammatory prevention and treatment of gouty arthritis.
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Affiliation(s)
- Robert Terkeltaub
- VA San Diego Healthcare System, 111K, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA. .,Department of Medicine, University of California San Diego, San Diego, CA, USA.
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