Optimising use of anti-inflammatory and anti-rheumatic medicines
Research type
Research Study
Full title
Medicines optimisation: improving safety and reducing treatment burden among people taking non-steroidal anti-inflammatory drugs or disease modifying anti-rheumatic drugs
IRAS ID
275305
Contact name
Simon Fraser
Contact email
Sponsor organisation
University of Southampton
Duration of Study in the UK
1 years, 9 months, 30 days
Research summary
Inflammatory conditions such as arthritis are common and safe pain relief options are limited. Anti-inflammatory drugs (NSAIDs) such as ibuprofen are widely used, but they have significant risks, such as bleeding from the stomach and kidney damage.
Another issue concerns people who are taking medications called ‘disease-modifying anti-rheumatic drugs’ (DMARDs). These drugs are used for rheumatoid arthritis and slow its progression, reducing the likelihood of joint damage and other health problems. They are also used for inflammatory bowel diseases. Methotrexate is a commonly used DMARD in arthritis and azathioprine in inflammatory bowel disease. Anti-TNF drugs are a group of ‘biological agents’ – another type of DMARD. DMARDs are powerful drugs that require regular blood tests to check for adverse effects, such as liver problems. However, for most people, these blood tests are almost never abnormal, and could potentially be done less frequently. In addition, some people with inflammatory arthritis have an excellent response to DMARDs. Stopping DMARDs can lead to flare ups of disease, but the amount of therapy used may be tapered successfully to reduce dose-dependent adverse events and costs.
We will use an anonymous database of about half a million people from GP practices in Hampshire to identify how many people are prescribed anti-inflammatory drugs and identify those who may be at high risk of complications. The aim is to help doctors spot people at high risk.
We will use the same dataset and also data from people attending University Hospitals Southampton who take methotrexate, azathioprine and anti-TNF drugs. We will examine their blood results to see if some people might not need blood tests so frequently.
We will also explore the possibility of dose-reduction strategies for anti-TNF drugs by identifying which kinds of patients tend to succeed in being able to reduce the dose.REC name
N/A
REC reference
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