Meta-analyses on the effects of Disease Modifying Anti-Rheumatic Drugs on the most relevant Patient-Reported Outcome domains in Rheumatoid Arthritis

Marijke van den Dikkenberg; Nathalie Luurssen-Masurel; Tjallingius Martijn Kuijper; Marc-Redwart Kok; Johanna Maria Wilhelmina Hazes; Pascal Hendrik Pieter de Jong; Deirisa Lopes-Barreto; Angelique Elisabeth Adriana Maria Weel-Koenders

doi:10.1002/acr.24965

Meta-analyses on the effects of Disease Modifying Anti-Rheumatic Drugs on the most relevant Patient-Reported Outcome domains in Rheumatoid Arthritis

Marijke van den Dikkenberg^*, Nathalie Luurssen-Masurel, Tjallingius Martijn Kuijper, Marc-Redwart Kok, Johanna Maria Wilhelmina Hazes, Pascal Hendrik Pieter de Jong, Deirisa Lopes-Barreto, Angelique Elisabeth Adriana Maria Weel-Koenders

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

1 Citation (Scopus)

Abstract

OBJECTIVE: Whereas in the treatment of rheumatoid arthritis much evidence exists on the effects of current pharmacologic treatment on clinical outcomes, little is known about the effects on patient-reported outcomes. This systematic review aims to evaluate the effects of disease-modifying antirheumatic drugs (DMARDs) on the patient-relevant domains of pain, fatigue, activity limitation, overall emotional and physical health impact, and work/school/housework ability and productivity.

METHODS: A literature search was conducted to identify randomized controlled trials wherein registered DMARDs were compared with placebo or methotrexate and reported the effects on patient-reported outcomes included in the International Consortium of Health Outcomes Measurement standard set for inflammatory arthritis. Random effects meta-analyses using the standardized mean differences of change scores as the effect measure were performed for the domains of pain, fatigue, and activity limitation, comparing DMARDs with placebo and methotrexate. The other 2 domains were presented narratively.

RESULTS: Across the 5 domains, 69 records belonging to 52 studies were identified. All meta-analyses showed a decrease of burden when DMARDs were compared with placebo (standardized mean differences [95% confidence interval] in pain -0.80 [-0.99, -0.61], fatigue -0.48 [-0.64, -0.32], and activity limitation -0.56 [- 0.63, -0.49]) and when compared with methotrexate (-0.55 [-0.70, -0.41), -0.44 [-0.55, -0.33], and - 0.37 [-0.44, -0.30], respectively).

CONCLUSION: DMARDs decrease the burden in all the domains that are relevant to patients. Effect sizes may be influenced by DMARD type. Therefore, in the decision for rheumatoid arthritis treatment, patient-reported outcomes should be taken into account.

Original language	English
Pages (from-to)	1659-1672
Number of pages	14
Journal	Arthritis Care and Research
Volume	75
Issue number	8
Early online date	3 Jun 2022
DOIs	https://doi.org/10.1002/acr.24965
Publication status	Published - Aug 2023

Bibliographical note

Funding Information:
We wish to thank two experienced librarians of the Erasmus Medical Center, Dr. Wichor Bramer and Dr. Elise Krabbendam for their help in developing the search strings, performing the search, and processing the identified records in EndNote.

Publisher Copyright:
© 2022 American College of Rheumatology.

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10.1002/acr.24965

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van den Dikkenberg, M., Luurssen-Masurel, N., Kuijper, T. M., Kok, M-R., Hazes, J. M. W., de Jong, P. H. P., Lopes-Barreto, D., & Weel-Koenders, A. E. A. M. (2023). Meta-analyses on the effects of Disease Modifying Anti-Rheumatic Drugs on the most relevant Patient-Reported Outcome domains in Rheumatoid Arthritis. Arthritis Care and Research, 75(8), 1659-1672. Advance online publication. https://doi.org/10.1002/acr.24965

@article{7713bcfbe89240b49ba652438d1c38ce,

title = "Meta-analyses on the effects of Disease Modifying Anti-Rheumatic Drugs on the most relevant Patient-Reported Outcome domains in Rheumatoid Arthritis",

abstract = "OBJECTIVE: Whereas in the treatment of rheumatoid arthritis much evidence exists on the effects of current pharmacologic treatment on clinical outcomes, little is known about the effects on patient-reported outcomes. This systematic review aims to evaluate the effects of disease-modifying antirheumatic drugs (DMARDs) on the patient-relevant domains of pain, fatigue, activity limitation, overall emotional and physical health impact, and work/school/housework ability and productivity.METHODS: A literature search was conducted to identify randomized controlled trials wherein registered DMARDs were compared with placebo or methotrexate and reported the effects on patient-reported outcomes included in the International Consortium of Health Outcomes Measurement standard set for inflammatory arthritis. Random effects meta-analyses using the standardized mean differences of change scores as the effect measure were performed for the domains of pain, fatigue, and activity limitation, comparing DMARDs with placebo and methotrexate. The other 2 domains were presented narratively.RESULTS: Across the 5 domains, 69 records belonging to 52 studies were identified. All meta-analyses showed a decrease of burden when DMARDs were compared with placebo (standardized mean differences [95% confidence interval] in pain -0.80 [-0.99, -0.61], fatigue -0.48 [-0.64, -0.32], and activity limitation -0.56 [- 0.63, -0.49]) and when compared with methotrexate (-0.55 [-0.70, -0.41), -0.44 [-0.55, -0.33], and - 0.37 [-0.44, -0.30], respectively).CONCLUSION: DMARDs decrease the burden in all the domains that are relevant to patients. Effect sizes may be influenced by DMARD type. Therefore, in the decision for rheumatoid arthritis treatment, patient-reported outcomes should be taken into account.",

author = "{van den Dikkenberg}, Marijke and Nathalie Luurssen-Masurel and Kuijper, {Tjallingius Martijn} and Marc-Redwart Kok and Hazes, {Johanna Maria Wilhelmina} and {de Jong}, {Pascal Hendrik Pieter} and Deirisa Lopes-Barreto and Weel-Koenders, {Angelique Elisabeth Adriana Maria}",

note = "Funding Information: We wish to thank two experienced librarians of the Erasmus Medical Center, Dr. Wichor Bramer and Dr. Elise Krabbendam for their help in developing the search strings, performing the search, and processing the identified records in EndNote. Publisher Copyright: {\textcopyright} 2022 American College of Rheumatology.",

year = "2023",

month = aug,

doi = "10.1002/acr.24965",

language = "English",

volume = "75",

pages = "1659--1672",

journal = "Arthritis Care and Research",

issn = "2151-464X",

publisher = "John Wiley & Sons Inc.",

number = "8",

}

van den Dikkenberg, M, Luurssen-Masurel, N, Kuijper, TM, Kok, M-R, Hazes, JMW, de Jong, PHP, Lopes-Barreto, D & Weel-Koenders, AEAM 2023, 'Meta-analyses on the effects of Disease Modifying Anti-Rheumatic Drugs on the most relevant Patient-Reported Outcome domains in Rheumatoid Arthritis', Arthritis Care and Research, vol. 75, no. 8, pp. 1659-1672. https://doi.org/10.1002/acr.24965

Meta-analyses on the effects of Disease Modifying Anti-Rheumatic Drugs on the most relevant Patient-Reported Outcome domains in Rheumatoid Arthritis. / van den Dikkenberg, Marijke; Luurssen-Masurel, Nathalie; Kuijper, Tjallingius Martijn et al.
In: Arthritis Care and Research, Vol. 75, No. 8, 08.2023, p. 1659-1672.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Meta-analyses on the effects of Disease Modifying Anti-Rheumatic Drugs on the most relevant Patient-Reported Outcome domains in Rheumatoid Arthritis

AU - van den Dikkenberg, Marijke

AU - Luurssen-Masurel, Nathalie

AU - Kuijper, Tjallingius Martijn

AU - Kok, Marc-Redwart

AU - Hazes, Johanna Maria Wilhelmina

AU - de Jong, Pascal Hendrik Pieter

AU - Lopes-Barreto, Deirisa

AU - Weel-Koenders, Angelique Elisabeth Adriana Maria

N1 - Funding Information: We wish to thank two experienced librarians of the Erasmus Medical Center, Dr. Wichor Bramer and Dr. Elise Krabbendam for their help in developing the search strings, performing the search, and processing the identified records in EndNote. Publisher Copyright: © 2022 American College of Rheumatology.

PY - 2023/8

Y1 - 2023/8

N2 - OBJECTIVE: Whereas in the treatment of rheumatoid arthritis much evidence exists on the effects of current pharmacologic treatment on clinical outcomes, little is known about the effects on patient-reported outcomes. This systematic review aims to evaluate the effects of disease-modifying antirheumatic drugs (DMARDs) on the patient-relevant domains of pain, fatigue, activity limitation, overall emotional and physical health impact, and work/school/housework ability and productivity.METHODS: A literature search was conducted to identify randomized controlled trials wherein registered DMARDs were compared with placebo or methotrexate and reported the effects on patient-reported outcomes included in the International Consortium of Health Outcomes Measurement standard set for inflammatory arthritis. Random effects meta-analyses using the standardized mean differences of change scores as the effect measure were performed for the domains of pain, fatigue, and activity limitation, comparing DMARDs with placebo and methotrexate. The other 2 domains were presented narratively.RESULTS: Across the 5 domains, 69 records belonging to 52 studies were identified. All meta-analyses showed a decrease of burden when DMARDs were compared with placebo (standardized mean differences [95% confidence interval] in pain -0.80 [-0.99, -0.61], fatigue -0.48 [-0.64, -0.32], and activity limitation -0.56 [- 0.63, -0.49]) and when compared with methotrexate (-0.55 [-0.70, -0.41), -0.44 [-0.55, -0.33], and - 0.37 [-0.44, -0.30], respectively).CONCLUSION: DMARDs decrease the burden in all the domains that are relevant to patients. Effect sizes may be influenced by DMARD type. Therefore, in the decision for rheumatoid arthritis treatment, patient-reported outcomes should be taken into account.

AB - OBJECTIVE: Whereas in the treatment of rheumatoid arthritis much evidence exists on the effects of current pharmacologic treatment on clinical outcomes, little is known about the effects on patient-reported outcomes. This systematic review aims to evaluate the effects of disease-modifying antirheumatic drugs (DMARDs) on the patient-relevant domains of pain, fatigue, activity limitation, overall emotional and physical health impact, and work/school/housework ability and productivity.METHODS: A literature search was conducted to identify randomized controlled trials wherein registered DMARDs were compared with placebo or methotrexate and reported the effects on patient-reported outcomes included in the International Consortium of Health Outcomes Measurement standard set for inflammatory arthritis. Random effects meta-analyses using the standardized mean differences of change scores as the effect measure were performed for the domains of pain, fatigue, and activity limitation, comparing DMARDs with placebo and methotrexate. The other 2 domains were presented narratively.RESULTS: Across the 5 domains, 69 records belonging to 52 studies were identified. All meta-analyses showed a decrease of burden when DMARDs were compared with placebo (standardized mean differences [95% confidence interval] in pain -0.80 [-0.99, -0.61], fatigue -0.48 [-0.64, -0.32], and activity limitation -0.56 [- 0.63, -0.49]) and when compared with methotrexate (-0.55 [-0.70, -0.41), -0.44 [-0.55, -0.33], and - 0.37 [-0.44, -0.30], respectively).CONCLUSION: DMARDs decrease the burden in all the domains that are relevant to patients. Effect sizes may be influenced by DMARD type. Therefore, in the decision for rheumatoid arthritis treatment, patient-reported outcomes should be taken into account.

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SN - 2151-464X

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Meta-analyses on the effects of Disease Modifying Anti-Rheumatic Drugs on the most relevant Patient-Reported Outcome domains in Rheumatoid Arthritis

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