THU0433 THE BURDEN OF OSTEOARTHRITIS PAIN FROM THE PATIENT’S PERSPECTIVE IN EUROPE
Authors: James Jackson, Wenhui Wen, Pavlina Hubanova, Nathan Williams, Jennifer Mellor, Ravi Iyer
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Pain, the primary symptom of osteoarthritis (OA), affects multiple aspects of a patient's life. <h3>Objectives:</h3> To evaluate the burden of OA pain from the patient's perspective in 5 European countries (France, Germany, Italy, Spain, the United Kingdom; EU5). <h3>Methods:</h3> 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 &amp; no opioid use vs those with no/mild pain &amp; opioid use; moderate/severe pain &amp; no opioid use; and moderate/severe pain &amp; opioid use. <h3>Results:</h3> 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 &amp; no opioid use; 11.2% (n=173) had no/mild pain &amp; opioid use; 32.8% (n=508) had moderate/severe pain &amp; no opioid use; and 21.6% (n=334) had moderate/severe pain &amp; opioid use. Patients with moderate/severe pain with or without opioid use had higher comorbidity burden compared with patients with no/mild pain &amp; no opioid use (Charlson Comorbidity Index: 0.7 and 0.4, respectively, vs 0.3, <i>P</i>&lt;.05) and were more likely to report physical mobility impacted by OA (87.2% and 77.0%, respectively, vs 51.2%; <i>P</i>&lt;.0001), need for a walking aid (68.6% and 46.6%, respectively, vs 36.4%; <i>P</i>&lt;.05), ever suffering a fall due to OA (45.8% and 30.8%, respectively, vs 24.1%; <i>P</i>&lt;.05), dissatisfaction with current OA treatment (39.1% and 25.7%, respectively, vs 6.6%; <i>P</i>&lt;.0001), poorer HRQoL (EQ-5D-5L utility score 0.5 and 0.6, respectively, vs 0.8; <i>P</i>&lt;.0001), higher overall activity impairment (66.8% and 59.7%, respectively, vs 31.1%, <i>P</i>&lt;.0001) and work impairment due to OA (employed patients only: 60.9% and 45.3%, respectively, vs 29.1%<i>, P</i>&lt;.0001). Patients with no/mild pain &amp; opioid use had poorer outcomes (<i>P</i>&lt;.05) vs no/mild pain &amp; no opioid use except for falls, treatment dissatisfaction, and work impairment due to OA. <h3>Conclusion:</h3> 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.&nbsp; <h3>References:&nbsp;</h3> N/A <h3>Disclosure of Interests:</h3> 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.