A signifiant number of patients with arthritis living in the UK are waiting too long for appropriate treatment, thus hindering their chances of achieving the best outcomes, suggests research by Merck Sharp & Dohme (MSD) and the National Rheumatoid Arthritis Society (NRAS).

A survey of 75 rheumatologists and 254 patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) found that the number of patients facing ‘unacceptable’ delays to see a specialist has steadily risen by more than 10% in the last decade.

According to the findings, 30% of patients had waited more than 12 weeks to see a specialist rheumatologist after presenting with symptoms to their GP, compared with 20% of those diagnosed in 2000-2005.

The 12-week timeframe for accurate diagnosis and treatment initiation is referred to as the "window of opportunity" by consultants, because it gives the best chance of a dramatic reduction in the risk of further pain and disability and associated costs.

Rheumatic diseases including RA and PsA represent a substantial health issue for the UK, with the societal cost estimated at £5.7 billion a year and accounting for the loss of 10 million working days. But "when appropriate treatment is started early, associated medical costs, disability and work limitations of these diseases can all be reduced," the groups stress.

Ailsa Bosworth, NRAS chief executive, said the findings are disappointing. There is an "urgent need" to address the lack of awareness among both the public and GPs about the symptoms and seriousness of rheumatoid arthritis, she noted, and also stressed the need "to treat possible early RA like cancer and get people referred and to see a specialist within 2-4 weeks".

Difference of opinion

The research also revealed a disparity in opinion on care and treatment priorities between specialists and patients.

For one, nearly all rheumatologists (97%) believe side effects are more important to their patients than they actually are, and only 40% believe feeling well enough to do the things they want to do it the priority.

But the survey showed that, for those patients on biologics, 96% cited reducing disease progression and feeling well enough to do the things they want to do as their most important consideration; while fewer (82%) said side effects would be the most important aspect.

Similarly, while 71% of rheumatologists consider side effects as the main reason for patients missing a treatment dose, just 23% and 17% of patients on biologics and non-biologics, respectively, said this is a reason. In fact, 44% of patients on biologics and 32% on non-biologics cited a life event as the main reason for missing a treatment dose, which should give specialists some food for thought.