Public opinion on social media is generally positive about disease modifying anti-rheumatic drugs (DMARDs), as posts by patients with rheumatoid arthritis (RA) show positive sentiment about the treatment, according to study results published in Annals of the Rheumatic Diseases.

As patient’s beliefs have a major impact on the adherence to treatment with DMARDs, it is important to understand patients attitudes towards DMARDs. Many patients use social media to discuss medical issues and analyzing social media content can provide valuable data on the collective sentiment expressed towards these medications.

Using the services of the web analytics firm Treato, a platform that identifies, collects, and analyses publicly available user-generated content on health-related topics, more than 3 billion posts from July 2017 till October 2018 were analyzed. A total of 28,261 posts on biological or targeted synthetic DMARDs and 26,841 posts on conventional synthetic agents were identified, with some overlap. Overall sentiment was expressed as a ratio of positive to negative posts for each DMARD, with a ratio of ≥ 1 indicating a positive assessment. In addition, analyses of the reasons for the sentiment for each DMARD were completed, focusing on efficacy and side effects.


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The data show that patients had an overall positive sentiment regarding both biological or targeted synthetic and conventional DMARDs, with a ratio of total positive to negative posts of 1.21 and 1.048, respectively. Efficacy was the most common theme in posts with a positive sentiment for all DMARDs.

The ratio of positive to negative posts for biological or targeted synthetic DMARDs ranged from 1.71 for tofacitinib to 1.08 for adalimumab. Comparing biological or targeted synthetic DMARDs to each other in terms of the proportion of patients who posted a positive post due to efficacy, revealed etanercept was more popular than rituximab, infliximab and tofacitinib.

The most common concerns raised by patients who wrote a negative post on biological or targeted synthetic were joint pains, itching, and rash. Hair loss, gastrointestinal issues and allergic reactions were the most common concerns raised by patients with a negative sentiment on conventional synthetic DMARDs.  

More patients on biological or targeted synthetic DMARDs were significantly more likely to positively post due to efficacy as compared with conventional synthetic DMARDs (85.74% vs. 78.71%, respectively; P <.0001). Concerns about medications were broadly similar in posts about both categories of DMARDs. However, joint pain, drug reactions and cancer were more common in posts about biological or targeted synthetic DMARDs, while weight loss, hair loss and nausea were more common in posts on conventional synthetic DMARDs.

The study had several limitations, including the quality of the data, lack of gold standard approach for sentiment analysis used for analyzing social media content, and exclusion of posts made in languages other than English.

“This study educates clinicians about the prevailing sentiment as it exists towards various DMARDs, and the specific concerns that patients have about the DMARDs. Thus, allowing them to better counsel their patients and prepare them for what they might encounter on their search online,” wrote the researchers.

Reference

Sharma C, Whittle S, Haghighi PD, Burstein F, Sa’adon R, Keen HI. Mining social media data to investigate patient perceptions regarding DMARD pharmacotherapy for rheumatoid arthritis. Ann Rheum Dis. 2020;79(11):1432-1437. doi:10.1136/annrheumdis-2020-217333