Results from two recent Harris Interactive(R) surveys of more than 450 European and Canadian rheumatologists provide new insights in two of the most common rheumatologic diseases: rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The surveys for the first time shed light on the treatment and identification of rapidly progressing disease (RPD) in rheumatoid arthritis (RA) patients and on the frequency and importance of non-joint inflammatory diseases in ankylosing spondylitis (AS) patients. The results were presented during the 2006 European League Against Rheumatism Annual European Congress of Rheumatology (EULAR).

Findings from the RA survey revealed that the majority of rheumatologists (85 percent) recognize rapidly progressing RA (resulting in irreversible structural damage to joints) as a distinct subtype of RA and place these patients in a separate treatment category. However, only one-third of rheumatologists are confident in their ability to easily recognize and treat patients with rapidly progressing RA. Among those rheumatologists surveyed, 84 percent reported that they use high inflammatory burden as a clinical marker of rapidly progressing disease in RA as well as a variety of other demographic and descriptive data including age, family history and gender. In addition, the majority of rheumatologists (79 percent) rated slowing the progression of joint erosion in their rapidly progressing RA patients as the most important treatment goal and state that these patients should be seen by their physician twice as often as stable RA patients.

Separately, the results of the AS survey indicate that the vast majority of rheumatologists surveyed agree that AS patients with one or more existing non-joint manifestations tend to have a poorer prognosis (85 percent) and poorer quality of life (92 percent) than patients suffering from axial (spine) and peripheral (non-spine) AS only. Yet, one out of three rheumatologists do not actively screen their AS patients for other inflammatory diseases, largely citing lack of clinical justification as their rationale. According to rheumatologists surveyed, the primary initial indicators of non-joint manifestations in AS patients are diarrhea (84 percent), skin/nail problems (80 and 71 percent, respectively), deteriorating vision (69 percent), unexplained weight loss or fever (67 percent), and family history (66 percent). In addition, rheumatologists identified biologics as their treatment of choice for AS patients with non-joint manifestations such as uveitis (45 percent) and Crohn's disease / ulcerative colitis (56 percent). They also reported that biologics are second only to methotrexate in the treatment of non-joint psoriasis (47 percent) and psoriatic arthritis (60 percent).

Other Key Findings - RA Survey:

- Rapid progression is attributed to a wide variety of underlying factors including: genetics (34 percent), a distinct, more aggressive disease (24 percent), and uncontrolled inflammation (23 percent)

- 70 percent of rheumatologists perceive critical impediments to identifying rapidly progressing disease, including: delayed evaluation and referral (18 percent), limited access to technology and equipment (13 percent), heavy caseloads and understaffing (12 percent), inconsistent contact with patients (11 percent), time and resource constraints (9 percent)

- 68 percent of rheumatologists also perceive patient non-compliance (15 percent) as critical impediments to treating rapidly progressing disease.

Other Key Findings - AS Survey

- Rheumatologists reported that approximately one out of every four AS patients screened for other inflammatory diseases presents with uveitis, psoriasis, or psoriatic arthritis; roughly one out of every six presents with Crohn's disease or ulcerative colitis.

- Most physicians acknowledge that underlying inflammation plays a significant role in causing non-joint manifestations; approximately one-third of rheumatologists do not.

- When treating AS patients with non-joint manifestations, rheumatologists maintain their focus on alleviating the symptoms of AS; less emphasis is placed on treating the non-joint manifestations; therapeutic goals are consistent across office- and hospital-based rheumatologists.

About the "Rapidly Progressing Disease" Rheumatologist Survey

Harris Interactive(R) interviewed a total of 458 rheumatologists in six countries ( Germany , France , Italy , Spain , UK and Canada ) beginning on April 18 and ending on May 15, 2006 . Survey inclusion criteria included the following: each rheumatologist must treat 10 or more RA patients in an average month, must prescribe biologic therapy for RA and must have been practicing for at least one year since completing medical training. All respondents were initially recruited by telephone, with 57 percent of rheumatologists completing the survey by phone and 43 percent responding online. Professor McInnes provided independent medical guidance to the development of the survey.

About the Ankylosing Spondylitis Rheumatologist Survey

Harris Interactive interviewed a total of 453 rheumatologists in six countries ( Germany , France , Italy , Spain , UK and Canada ) beginning on April 18 and ending on May 15, 2006 . To qualify for the survey, rheumatologists had to treat three or more AS patients in an average month, prescribe biologic therapy for AS patients and be in practice for at least one year since completing medical training. All respondents were initially recruited by telephone, with 56 percent of rheumatologists completing the survey by phone and 44 percent responding online. Dr. Van den Bosch provided independent medical guidance to the development of the survey.

About RA

Rheumatoid arthritis (RA) is a chronic, debilitating inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. Symptoms of RA include inflammation of the joints, swelling, difficulty moving, and pain. The most commonly affected joints are the hands and feet. The joint pain of RA can impact a patient's ability to perform normal daily activities, limit job opportunities, and make family and household responsibilities a challenge. RA afflicts more than 9.7 million people worldwide; according to the World Health Organization, the incidence of RA in Europe is expected to increase over the next decade as the population ages.

 
About Ankylosing Spondylitis

AS is a painful and progressive form of spinal arthritis that usually affects people under the age of 35 years. It typically begins in the late teens and early twenties and can result in fusing of the spinal vertebrae, hips and other joints. Often misdiagnosed as "just back pain" (mechanical back pain) or undifferentiated arthritis, AS is a systemic inflammatory disease that in addition to its effect on the spine, can affect vision, internal organs, and peripheral joints. According to the Arthritis Research Campaign, AS affects up to 0.5 percent of the population. On the European continent, it is estimated that prevalence ranges from 0.2 to 1 percent of the entire population. The Spondylitis Association of America (SAA) estimates that between 350,000 and one million people in the United States suffer from AS or a related disease.

  (27/6/06)