Abstract
AbstractTumor necrosis factor inhibitor (TNFi) therapies are often the first biologic therapy used to treat rheumatoid arthritis (RA) patients. However, a substantial fraction of patients do not respond adequately to TNFi therapies. A test with the ability to predict response would inform therapeutic decision-making and improve clinical and financial outcomes. A 32-question decision-impact survey was conducted with 248 rheumatologists to gauge the perceived clinical utility of a novel test that predicts inadequate response to TNFi therapies in RA patients. Participants were informed about the predictive characteristics of the test and asked to indicate prescribing decisions based on four result scenarios. Overall, rheumatologists had a favorable view of the test: 80.2% agreed that it would improve medical decision-making, 92.3% said it would increase their confidence when making prescribing decisions, and 81.5% said it would be useful when considering TNFi therapies. Rheumatologists would be more likely to prescribe a TNFi therapy when the test reported that no signal of non-response was detected (79.8%) and less likely to prescribe a TNFi therapy when a signal of non-response was detected (11.3%–25.4%). Rheumatologists (84.7%) agreed that payers should provide coverage for such a test. This study shows that rheumatologists support the clinical need for a test to predict inadequate response to TNFi therapies. Test results were perceived to lead to changes in prescribing behaviors as results instill confidence in the ordering rheumatologist.
Funder
Scipher Medicine Corporation
Publisher
Springer Science and Business Media LLC
Subject
Immunology,Immunology and Allergy,Rheumatology
Reference31 articles.
1. Hunter TM, Boytsov NN, Zhang X, Schroeder K, Michaud K, Araujo AB (2017) Prevalence of rheumatoid arthritis in the United States adult population in healthcare claims databases, 2004–2014. Rheumatol Int 37(9):1551–1557
2. Bluett J, Barton A (2017) Precision medicine in rheumatoid arthritis. Rheum Dis Clin N Am 43(3):377–387
3. Singh JA, Saag KG, Bridges SL Jr et al (2016) 2015 American College of Rheumatology Guideline for the treatment of rheumatoid arthritis. Arthr Care Res 68(1):1–25
4. Curtis JR, Zhang J, Xie F et al (2014) Use of oral and subcutaneous methotrexate in rheumatoid arthritis patients in the United States. Arthr Care Res 66(11):1604–1611
5. Cigna Medical and Administrative A-Z Index (2020). https://static.cigna.com/assets/chcp/resourceLibrary/coveragePolicies/medical_a-z.html. Accessed 27 July 2020
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献