Global Healthy Living Foundation

EULAR23: Dr. Nowell Discusses Rheumatoid Arthritis Patients’ Perceptions About Multiple Required Blood Tests Interview with:

W. Benjamin Nowell

Dr. Nowell

W. Benjamin Nowell PhD
Director of Patient-Centered Research at Global Healthy Living Foundation
Columbia University in the City of New York
New York, New York What is the background for this study?

Response: Given that lab tests are an important part of rheumatoid arthritis (RA) diagnosis and monitoring, people living with the condition want and need to understand their lab results –also known as blood work – for patient-centered shared decision making about treatment. The presentation titled, “Patient Perceptions of Rheumatoid Arthritis Blood Work and Utility of a Test Predicting Response to New Medication: A Cross-sectional Survey in the ArthritisPower,” presented at the 76th EULAR European Congress of Rheumatology (June 2, 2023 in Milan, Italy) includes results from a recent ArthritisPower survey (n=405) that asked patients to share their perceptions about RA bloodwork, reasons their doctor orders these tests, and how results are used. What are the main findings?

Response:  We found that most patients understood that their doctor ordered laboratory tests to check for active inflammation (85.9%) or assess side effects of medications (81.2%). However, nearly all (86%) feared that their current RA medication would stop working and that they would waste time trying to find (81.7%) an alternative, effective therapy. Of the many lab tests available, forty-nine percent of patients felt that the C-reactive protein (CRP) test was most helpful among available tests to understand their own disease activity. In the event of needing to start a new treatment, nearly all patients were very or extremely interested in a hypothetical blood test that could help to accurately predict whether such new medication would be effective for them (89.2%). What should readers take away from your report?

Response: The experienced patient expects blood work at routine rheumatology visits. However, to feel engaged in treatment decision making, people living with rheumatoid arthritis need to understand why their rheumatologist orders certain tests versus others and how results will guide choices made for future care.

Blood work is only part of the portfolio of information about a person’s RA and its impact, along with clinical examination and joint count, imaging, and patient report of symptoms.

The possibility that blood work results and other information might indicate that disease activity is not well controlled is worrying to patients. What if their medication is no longer effective against their disease? Switching and trying medications in RA can be time consuming (and frustrating) since many can take months to assess if they are effective in an individual.

Therefore, patients expressed a desire for more personalized and directive tests – one that can point to the medication that might work best for them. What recommendations do you have for future research as a results of this study?

Response: This study demonstrates that patients understand the value of blood work, even when they may not fully comprehend how to interpret results and apply them to decisions about care and treatment. However, it also highlights the need for biomarker tests that can predict which types of medications are most likely to be effective for an individual patient, which is a goal of personalized medicine. Future research should explore the development of more specialized testing across the variety of rheumatoid arthritis treatment options. Of course, this is a large undertaking, but one that could greatly improve the efficiency of disease management.

Disclosures: This study in ArthritisPower was funded by Scipher Medicine. Infrastructure support for the ArthritisPower registry was provided in part by NIAMS P30AR072583. Dr. Nowell is Principal Investigator on grants and contracts from AbbVie, Amgen, Janssen and Scipher Medicine.

Citation: EULAR 2023

Patient Perceptions of Rheumatoid Arthritis Blood Work and Utility of a Test Predicting Response to New Medication: A Cross-sectional Survey in the ArthritisPower

W. B. Nowell1, S. Venkatachalam1, K. Gavigan1, M. George2, J. Withers3, L. Stradford1, E. Rivera1, J. Curtis4
1Global Healthy Living Foundation, Research, Nyack, United States of America
2University of Pennsylvania, Rheumatology, Philadelphia, United States of America
3Scipher Medicine, Research, Waltham, United States of America
4University of Alabama at Birmingham, Rheumatology, Birmingham, United States of America

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Last Updated on June 6, 2023 by Marie Benz