Reducing biologic therapy in Inflamatory Arthritis: Patient perception
Research type
Research Study
Full title
Understanding patient perceptions of dose reduction for biologic therapy in inflammatory arthritis: a qualitative study
IRAS ID
221285
Contact name
Sarah Hewlett
Contact email
Sponsor organisation
University of the West of England
Duration of Study in the UK
0 years, 5 months, 30 days
Research summary
12 years ago a new class of drugs was introduced for the treatment of some forms of inflammatory arthritis including rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. These drugs, sometimes called “biologic therapies” are quite different as they are “designer drugs” specifically developed to block certain parts of the immune system, which drive inflammation. They are also very expensive, costing about £9000 per year. They have been extremely helpful, especially for patients who have tried and failed other traditional therapies. In many patients we can now offer the hope of remission. Unfortunately, as with all drugs, these new drugs have potential side effects including local reactions, infections and possibly a small rise in the long-term risk of cancer. We currently have very good advice on when and how to start these drugs but much less is known on when we should stop them.
Recently, rheumatologists in North Bristol NHS Trust (and also in other parts of the UK and the world) suggest that when certain patients have been stable for some time they may wish to reduce the dose of their drug, just as we would do with any other drug. The aim is to offer patients the smallest dose of drug that they need to keep their symptoms under control. That way we can minimise the risk of side effects while also saving money. A lot of research has been done to show that doses can be safely reduced in many patients but at the moment we know very little about what patients think about the idea of dose reduction and this represents a specific gap in our knowledge. It means we are unaware of how best to provide information to patients regarding this part of their disease management.
The aim of this study is to undertake detailed one to one interviews with a selection of patients attending the Rheumatology Department at two Bristol hospitals. By doing this we will understand more about patients’ perceptions and can perhaps allay any concerns they may have about reducing the dose of drug. We believe that involving patients and understanding the patient perspective is vital for our continued delivery of the best possible service and treatment options.
REC name
West of Scotland REC 1
REC reference
17/WS/0014
Date of REC Opinion
20 Jan 2017
REC opinion
Favourable Opinion