Non-adherence in Inflammatory arthritis
Research type
Research Study
Full title
The diagnostic application of liquid chromatography–mass spectrometry for studying the nonadherence in inflammatory arthritis
IRAS ID
235638
Contact name
Veena Patel
Contact email
Sponsor organisation
UHL
Duration of Study in the UK
1 years, 0 months, days
Research summary
Inflammatory arthritis (IA) is a group of progressing chronic auto-inflammatory conditions affecting patients at a younger age group leading to increasing joint pain, swelling and disability. The most common of these are rheumatoid and psoriatic arthritis. Standard treatment of these is with disease modifying anti-rheumatic drugs (DMARDs). Patients who do not achieve satisfactory control with these drugs can be considered for escalation to biological treatments. The biological agents are more expensive and have more risks associated with them, including more profound immune suppression than DMARDs and higher chance of malignancies.
Non-adherence among chronic conditions is major health issue. Many IA patients fail to achieve remission, resulting in progression of the disease along with functional deterioration. This has a huge impact on the human and financial resources i.e. additional clinic visits, blood tests and dangerous escalation of treatment. Given the complexity of the condition and individual response to DMARDs, it is challenging to predict whether loss of disease control in these cases is due to the progression of the disease itself or to non- adherence to DMARDs. Having a direct measure of whether patients are taking their DMARDs would help clinicians decide appropriately on the judicious escalation to the use of immunosuppressive drugs.
Our aim with this study is to use Liquid Chromatography- Tandem Mass Spectrometry (LC-MS/MS) to estimate the non-adherence rate to DMARDs among our patients with Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PsA) who are being considered for escalation to biological therapies during their routine review in the rheumatology clinics. We will be testing those who are taking methotrexate, hydroxycholorquine , sulfasalazine , leflunomide and azathioprine. Finding the DMARD adherence rate with aim of improving adherence among these patients would help with service planning, including whether we should have non-adherence screening as a routine clinical service.REC name
HSC REC A
REC reference
23/NI/0014
Date of REC Opinion
25 Jan 2023
REC opinion
Further Information Favourable Opinion