THU0433 THE BURDEN OF OSTEOARTHRITIS PAIN FROM THE PATIENT'S PERSPECTIVE IN EUROPE. (June 2019)

• Record Type: Journal Article
• Authors: Jackson, James; Wen, Wenhui; Hubanova, Pavlina; Williams, Nathan; Mellor, Jennifer; Iyer, Ravi
• Is Part Of: Annals of the rheumatic diseases. Volume 78(2019)Supplement 2
• Page Start: 504
• Page End: 505
• Publication Date: 2019-06
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2019-eular.5142
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Pain, the primary symptom of osteoarthritis (OA), affects multiple aspects of a patient's life. Objectives: To evaluate the burden of OA pain from the patient's perspective in 5 European countries (France, Germany, Italy, Spain, the United Kingdom; EU5). Methods: This real-world cross-sectional study used data from the 2017 EU5 Adelphi OA Disease Specific Programme, a survey of physicians and their OA patients. Physicians completed a Patient Record Form on need for treatment, opioid use, and comorbidities. The patient-completed questionnaire included assessment of pain and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), health-related quality of life (HRQoL; EuroQol 5-dimension 5-level [EQ-5D-5L]), activity/productivity impairment (OA-specific Work Productivity and Activity Impairment questionnaire), and other functional limitations (e.g., need for walking aid, suffered a fall). Patients with hip/knee OA diagnosed by physicians were stratified by their current OA pain intensity (no/mild pain [WOMAC score 0–3] or moderate/severe pain [WOMAC score ≥4]) and opioid use. Multivariate testing was used to compare outcomes for patients with no/mild pain & no opioid use vs those with no/mild pain & opioid use; moderate/severe pain & no opioid use; and moderate/severe pain & opioid use. Results: The study included 1, 547 patients with hip/knee OA (55.0% knee only, 26.8% hip only, 18.2% both hip and knee; mean [SD] age 66.8 [11.1] years; 57.0% female). Among this sample, 34.4% of patients (n=532) had no/mild pain & no opioid use; 11.2% (n=173) had no/mild pain & opioid use; 32.8% (n=508) had moderate/severe pain & no opioid use; and 21.6% (n=334) had moderate/severe pain & opioid use. Patients with moderate/severe pain with or without opioid use had higher comorbidity burden compared with patients with no/mild pain & no opioid use (Charlson Comorbidity Index: 0.7 and 0.4, respectively, vs 0.3, P <.05) and were more likely to report physical mobility impacted by OA (87.2% and 77.0%, respectively, vs 51.2%; P <.0001), need for a walking aid (68.6% and 46.6%, respectively, vs 36.4%; P <.05), ever suffering a fall due to OA (45.8% and 30.8%, respectively, vs 24.1%; P <.05), dissatisfaction with current OA treatment (39.1% and 25.7%, respectively, vs 6.6%; P <.0001), poorer HRQoL (EQ-5D-5L utility score 0.5 and 0.6, respectively, vs 0.8; P <.0001), higher overall activity impairment (66.8% and 59.7%, respectively, vs 31.1%, P <.0001) and work impairment due to OA (employed patients only: 60.9% and 45.3%, respectively, vs 29.1%, P <.0001). Patients with no/mild pain & opioid use had poorer outcomes ( P <.05) vs no/mild pain & no opioid use except for falls, treatment dissatisfaction, and work impairment due to OA. Conclusion: In this EU cohort, patients with moderate/severe OA pain reported significant burdens that comprised greater treatment needs; more comorbidities; and reductions in physical functioning, HRQoL, and work productivity and daily activities. Patients with moderate/severe OA pain and opioid use experienced the highest burdens. These results demonstrate the multidimensional impact of OA pain on a patient's life and underscore an unmet need for more effective treatment options for OA pain. References: : N/A Disclosure of Interests: James Jackson Consultant for: Regeneron Pharmaceuticals, Inc., and Teva Pharmaceutical Industries, Wenhui Wen Employee of: Regeneron Pharmaceuticals, Inc., Pavlina Hubanova Consultant for: Regeneron Pharmaceuticals, Inc., and Teva Pharmaceutical Industries, Nathan Williams Consultant for: Regeneron Pharmaceuticals, Inc., and Teva Pharmaceutical Industries, Jennifer Mellor Consultant for: Regeneron Pharmaceuticals, Inc., and Teva Pharmaceutical Industries, Ravi Iyer Employee of: Teva Pharmaceutical Industries Ltd.