Burden of adverse drug reactions associated with disease modifying anti-rheumatic drugs in rheumatoid arthritis patients.
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Abstract Background: The burden of ADRs related to treatments of various diseases are lesser known or not thoroughly defined. Rheumatoid arthritis is a complex disease with many different therapeutic options used to slow down disease progression and improve the quality of life for the people dealing with this disease. The aim of this article is to assess and compare the burden of the ADRs of DMARDs in patients with rheumatoid arthritis. Methods: This was a cross-sectional study of data collected in the Dutch ADR Monitor, with patients being sent bimonthly questionnaires. A section of these questionnaires contained follow up questions specifically focused on the burden of any reported ADRs caused by one or multiple DMARDs used for treatment of the RA patients. The burden of these ADRs could be reported for the following seven domains: appearance, medical treatment, daily activities, fatigue, mental health, physical and course. The burden scores per drug group were displayed using a likert type scale. Data was analyzed using Kruskal Wallis and Dunn tests, and presented using a ten point likert type scale. Results: A total of 48 rheumatoid arthritis patients were included (71.4% female) and reported 78 ADRs. In the mental health domain a significant difference (p=0.044) was found between bDMARDs and csDMARDs. As a whole csDMARDs don’t have a higher or lower burden than other DMARDs or corticosteroids. Conclusion: These results provide a first look into what burden data could add to current and future treatment considerations. The currently available data shows bDMARDs being more burdensome than csDMARDs in the mental health domain. A larger sample size or database will allow for other and more observations to be made in the future.