Osteoarthritis patients 'willing to accept treatment-associated risks'

A new study has shed light on osteoarthritis patients' willingness to accept risks associated with treatments, as long as they are confident in the drug's possible benefits.

Led by the Yale University School of Medicine and VA Connecticut Healthcare System in the US and Canada's University of Toronto and McMaster University, the research aimed to quantify patient preferences for potential disease-modifying anti-rheumatic drugs for osteoarthritis (DMOADs), of which there are numerous new candidates currently emerging, including methotrexate and hydroxychloroquine, both currently routinely used to treat rheumatoid arthritis.

As such, they conducted a survey of 304 patients attending outpatient general medicine and specialty clinics, who were asked in waiting rooms if they would be willing to participate in a poll to gauge opinions on arthritis treatments.

Simulations were carried out to estimate preferences for a number of options to prevent worsening of knee osteoarthritis, with each choice demonstrating variations in terms of benefit, risks, cost and method of administration.

Results published in the journal Arthritis Care & Research revealed that 59.2 per cent of the patients showed a strong preference for receiving DMOADs, regardless of the benefit-risk profile.

By contrast, 20 per cent were identified as being risk-sensitive and willing to take DMOADs only under the best-case scenario - that is to say, a cheap, pill-based therapy with proven benefits and low risk - but would start rejecting medications as risk increased.

Meanwhile, 16.4 per cent said they would reject DMOADs under all circumstances, with five per cent declining subcutaneous injections out of hand, while adding they would only consider DMOADs under the best-case scenario.

The study concluded: "Our results suggest that a significant percentage of a non-selected outpatient population might be willing to accept at least a moderate degree of risk in order to prevent worsening knee osteoarthritis."

Arthritis Research UK is currently funding two clinical trials testing the effectiveness of methotrexate for knee osteoarthritis and hydroxychloroquine for osteoarthritis of the hand.

"There's increasing evidence that inflammation plays an important part in osteoarthritis, so drugs used to treat inflammatory arthritis may also be effective in osteoarthritis," said a spokeswoman for the charity. "By reducing inflammation, it could also reduce pain and even slow down the structural deterioration of affected joints."

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