Dr. Ben Nowell PhD Director of Patient-Centered Research Global Healthy Living Foundation Co-Principal Investigator of CreakyJoints ArthritisPower 

Despite Many New Meds, 74% of RA Patients Expressed Dissatisfaction with Their Treatment

MedicalResearch.com Interview with:

Dr. Ben Nowell PhD Director of Patient-Centered Research Global Healthy Living Foundation Co-Principal Investigator of CreakyJoints ArthritisPower 

Dr. Ben Nowell

W. Benjamin Nowell, Ph.D.
Director of Patient-Centered Research
CreakyJoints, Principal Investigator of ArthritisPower

MedicalResearch.com: What is the background for this study?

Response: Over the past fifteen years, the treatment options for people diagnosed and living with rheumatoid arthritis (RA) have grown. There are now many medications (particularly biologic disease-modifying antirheumatic drugs, or bDMARDs) proven to improve disease symptoms and immune system over activity, thereby reducing inflammation and joint damage. The American College of Rheumatology recommends a treat-to-target approach, which has the patient and rheumatologist setting goals for treatment effectiveness and making adjustments over time to meet those goals.

This study aimed to determine if rheumatoid arthritis patients are satisfied with their treatment. The goal of this study was to identify the following: patients’ satisfaction with current RA treatment, the current unmet needs perceived by patients with rheumatoid arthritis in the United States, the symptoms of rheumatoid arthritis that are most bothersome to patients, and the impact of symptoms on function and quality of life that may lead patients to need alternative treatments. 

MedicalResearch.com: What are the main findings?

Response: The study found that nearly three-fourths of people with rheumatoid arthritis responding to our survey (n=258) expressed dissatisfaction with their treatments, despite the variety of available medications including bDMARDs. Even on treatment, respondents experienced bothersome symptoms, such as fatigue (82%), pain (76%) and physical limitations (75%), which negatively impacted their quality of life. The study also found that despite active treatment to reduce inflammation and pain, most respondents with RA still had either moderate disease activity (37%) or high disease activity (33%) while very few reported achieving remission (16%) or low disease activity (13%) with their current treatment. Of those individuals who expressed dissatisfaction with their treatment, approximately half reported currently experiencing a flare (a period of exacerbated symptoms).

This study was a cross-sectional, 50-item, web-based survey of patients with rheumatoid arthritis who were enrolled in ArthritisPower®, the online patient research registry of CreakyJoints.

MedicalResearch.com: What should readers take away from your report?

Response: Our study suggests that there are unmet treatment needs in the rheumatoid arthritis patient community and it raises questions about why patients do not change their medications when they experience persistent moderate to high disease activity on their current treatment, as recommended by a treat-to-target approach. Possibly, patients and physicians perceive disease activity differently or fail to have a frank discussion about available options for adjusting treatment to improve disease control.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Rheumatoid Arthritis guidelines encourage striving for well-controlled disease and, ideally, remission. Yet this survey demonstrates that many patients continue to live with destructive levels of disease activity and debilitating symptoms. At CreakyJoints, we believe that patient insights from patient-reported outcomes, such as those we examine in ArthritisPower, are vital to successful management of a chronic disease like rheumatoid arthritis since they help communicate the experience of disease from the patients’ perspective over time. Future studies should evaluate how the use of standardized clinician tools and tests, combined with patient reported outcomes collected longitudinally, might enhance the conversations between patients and providers to improve treat-to-target implementation. 


Rheumatology and Therapy

September 2019, Volume 6, Issue 3, pp 461–471|

Patient Perceptions of Unmet Medical Need in Rheumatoid Arthritis: A Cross-Sectional Survey in the USA

Christine Radawski, Mark C. Genovese, Brett Haube, W. Benjamin Nowell, Kelly Hollis, Carol L. Gaich, Amy M. Deozier, Kelly Gavigan, Maria Reynolds, Anabela Cardoso, Jeffrey R. Curtis

First Online: 06 August 2019



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Last Updated on September 12, 2019 by Marie Benz MD FAAD