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Stephanie D Taylor,1 Sharlette V Everett,1 Thomas N Taylor,2 Douglas J Watson,3 Gavin Taylor-Stokes4 1Global Health Outcomes, Merck Sharp and Dohme Corp, Whitehouse Station, NJ, USA; 2Pharmacy Practice, Wayne State University, Detroit, MI, USA; 3Epidemiology, Merck Sharp and Dohme Corp, Upper Gwynedd, PA, USA; 4Adelphi Real World, Macclesfield, UK Purpose: The clinical response to traditional nonsteroidal anti-inflammatory drugs (tNSAIDs) varies substantially. The objective of this study was to describe physicians’ and patients’ perceptions of response to tNSAIDs as measured by satisfaction with control of patients’ osteoarthritis (OA). Patients and methods: A cross-sectional survey was undertaken in 2009 in Germany, Spain, and the UK. Linked physician and patient questionnaires collected data on OA management, degree of pain and disability, and satisfaction with OA control. Results: The study included 363 treating physicians and 713 patients receiving tNSAIDs. Patient mean (standard deviation) age was 65.5 (11.0) years (range 36–94 years); 60% were women; 86% were white; and one-quarter were obese. Dissatisfaction with control of patients’ OA was expressed by physicians or their patients, or both, for 51% of patients, including 208 patients (31%) with mild OA and 478 patients (60%) with moderate or severe OA. Overall, 37% of patients reported dissatisfaction and 34% had a physician who reported dissatisfaction. Patient and physician assessments were the same in 70% of cases; Cohen’s κ coefficient was 0.34 (95% confidence interval 0.26–0.41), indicating fair agreement. Of those reporting dissatisfaction, most physicians (79%) and patients (64%) believed that the current control was the best that could be achieved. The most common reasons for which physicians reported dissatisfaction were inadequate response (56%), side effects (11.1%), and poor tolerance (7.8%). Conclusion: One-half of patients or their treating physicians were dissatisfied with the control of OA provided by tNSAID therapy; moreover, most believed it was the best control that could be achieved. Keywords: cross-sectional, dissatisfaction, pain, survey

Gavin Taylor-Stokes1, James Pike1, Alesia Sadosky2, Arthi Chandran2, Thomas Toelle31Adelphi Real World, Adelphi Mill, Bollington, Macclesfield, Cheshire, UK; 2Pfizer Inc, New York, NY, USA; 3Department of Neurology, Technische Universität München, Munich, GermanyObjective: To evaluate the association of patient-reported severity of painful diabetic peripheral neuropathy (pDPN) with other outcomes in a European population of patients using the Adelphi Disease Specific Programme for pDPN (DSP III, 2008).Methods: The severity of patients' pDPN (mild, moderate, or severe) was rated independently by both patients and physicians. Relationships were evaluated between patient-reported pDPN severity and other patient-reported outcomes including pain, sleep, function, and work productivity. Physicians rated the severity of patients’ pDPN (1 = mild, 2 = moderate, 3 = severe) and sleep interference.Results: Patient-reported data were available from 634 individuals (56.2% male, mean age 63 years) from France, Germany, Italy, and the UK, of whom only 22.2% reported that they were currently employed. pDPN severity was rated as mild, moderate, and severe by 22.2%, 60.9%, and 16.9% of the patients, respectively. There was a significant association between patient-rated and physician-rated pDPN severity (P < 0.0001), although there were discrepancies in agreement (kappa = 0.37, 95% confidence interval [CI] 0.31, 0.43; weighted kappa = 0.43, 95% CI 0.37, 0.48) among physician and patient ratings in a substantial proportion of patients across severity categories. Higher pDPN severity was associated with greater interference of daily function including sleep (P < 0.0001 for all pairwise comparisons). Among employed patients, percent of pDPN-related impairment while at work (presenteeism) and overall work impairment increased with greater pDPN severity, resulting in indirect costs that increased significantly with pDPN severity; $8266, $15,449, and $24,300 for mild, moderate, and severe pDPN, respectively (overall P < 0.001).Conclusion: Severity of patient-rated pDPN was significantly associated with outcomes, including function and productivity; poorer function and lower productivity were reported at higher pDPN severity levels. Moreover, physicians rated pDPN severity different from patients in a substantial proportion of patients.Keywords: diabetic neuropathy, pain, outcomes

Le raltegravir 1200 mg une fois par jour (RAL 1200 QD) est disponible en Angleterre depuis septembre 2017. Cette étude est la première à décrire la population dans laquelle RAL 1200 QD est prescrit en en vie réelle. Les objectifs primaires de l'étude sont la description démographique des patients, de leurs caractéristiques cliniques et thérapeutiques à l'inclusion. Les traitements antirétroviraux (ART) initiés avec RAL 1200 QD sont également analysés. Les données ont été collectées rétrospectivement avec un formulaire standardisé à partir des dossiers de 300 patients utilisant au moins une dose de RAL 1200 QD depuis sa mise à disposition et ayant eu une consultation de suivi à 6 mois (intervalle autorisé entre 5 et 9 mois) à Londres ou à Manchester. Sur les 300 sujets inclus, 255 (85 %) étaient des hommes, dont 182/255 (71 %) ayant des rapports sexuels avec des hommes, 56 % étaient caucasiens. L'âge médian au diagnostic et celui à l'initiation de RAL 1200 QD étaient 34 ans (18–86) et 45 ans (21–96) respectivement. Cinquante-six (19 %) étaient utilisateurs de substances récréatives, dont 5 (9 %) rapportant une pratique de chemsex. Deux cent quatre-vingt-cinq avaient déjà utilisé un ART (ART-E) et 15 étaient naïfs de traitement (TN). La charge virale (CV) à l'inclusion (BL) et le taux de CD4+ étaient disponibles pour 283 et 248 sujets ART-E respectivement ; 94 % avaient une CV à BL < 50 c/mL, et 96 % < 200 c/mL. Cinq pour cent des sujets ART-E avaient un taux de CD4+ ≤ 200 vs 20 % pour les TN. À BL, 60 % recevaient un traitement non-ART et 68 % avaient des comorbidités, les plus fréquentes étant une hyperlipidémie, une dépression, et une hypertension chez 68 (23 %), 56 (19 %) et 51 (17 %) sujets respectivement. Deux cent cinq (68 %) ont initié un traitement par TDF/FTC et 46 (15 %) par ABC/3TC. Quatre sur 267 (1 %) ayant une CV à BL < 50 c/mL, et 10/300 (3 %) des sujets ayant initié un traitement par RAL 1200 QD avaient une CV > 50 c/mL à la visite de suivi. À 6 mois, 21 (7 %) avaient arrêté RAL 1200 QD. En vie réelle, les patients initiant un traitement par RAL 1200 QD sont comparables aux populations des essais cliniques : ce sont majoritairement des HSH caucasiens. Cependant, ils débutent le traitement à un âge plus avancé, ont un fardeau de la maladie plus important, avec des comorbidités significatives et des co-médications importantes. Les arrêts de traitement et les mesures de la CV se situent dans les objectifs ONUSIDA 90 :90 :90. [ABSTRACT FROM AUTHOR]