Publications by authors named "Hebing R"

Aims: Methotrexate (MTX) is the cornerstone in the treatment of rheumatoid arthritis (RA) patients. However, adherence to MTX therapy is not optimal, and instruments to assess medication nonadherence are warranted. To date there is no consensus on the best method to determine adherence to MTX.

View Article and Find Full Text PDF

Purpose: This review aims to critically evaluate the potential benefit of either oral or subcutaneous administration of methotrexate (MTX) in various immune-mediated inflammatory disorders (IMIDs) through analysis of efficacy, toxicity, pharmacokinetics and pharmacodynamics of both administration routes.

Recent Findings: Recent studies comparing the efficacy of oral versus subcutaneous MTX administration in IMIDs have revealed contradicting results. Some reported higher efficacy with subcutaneous administration, while others found no significant difference.

View Article and Find Full Text PDF

Methotrexate polyglutamates (MTX-PG) concentrations in red blood cells (RBCs) have been suggested as a biomarker of response in patients with rheumatoid arthritis (RA) receiving low-dose MTX therapy. We investigated the association and interpatient variability between RBC-MTX-PG -exposure and response in patients with RA starting MTX. Data of three prospective cohorts were available.

View Article and Find Full Text PDF

Objective: To investigate the pharmacokinetics of methotrexate polyglutamate (MTX-PG) accumulation in red blood cells (RBCs) and peripheral blood mononuclear cells (PBMCs) in patients with early rheumatoid arthritis (RA) after oral and subcutaneous MTX treatment.

Methods: In a clinical prospective cohort study (Methotrexate Monitoring study), newly diagnosed patients with RA were randomised for oral or subcutaneous MTX. At 1, 2, 3 and 6 months after therapy initiation, blood was collected and RBCs and PBMCs were isolated.

View Article and Find Full Text PDF

Objective: To examine the effect on adherence to disease modifying anti-rheumatic drugs (DMARDs) in participants with rheumatoid arthritis (RA) of a serious game that targeted implicit attitudes toward medication.

Methods: A multicentre randomised controlled trial (RCT) was performed with adults with RA that used DMARDs and possessed a smartphone/tablet. Control and intervention groups received care as usual.

View Article and Find Full Text PDF
Article Synopsis
  • * A meta-analysis of 25 studies found that higher MTX-PG levels in patients with rheumatoid arthritis, juvenile idiopathic arthritis, and psoriasis correlated with lower disease activity at various time points.
  • * The results support the need for therapeutic drug monitoring (TDM) in clinical practice, indicating that individualized MTX dosing could improve the management of IMIDs by effectively reducing symptoms.
View Article and Find Full Text PDF

Objective: Medication non-adherence in rheumatoid arthritis (RA) is associated with disease flares, increased disability and increased costs. This study assessed the effectiveness of electronic monitoring feedback (EMF) on medication adherence in patients with RA starting with or switching to a new biological disease-modifying antirheumatic drug (bDMARD).

Methods: In this randomised controlled trial, bDMARD starters were assigned to the intervention or control group and followed for 1 year.

View Article and Find Full Text PDF

Introduction: Although the burden of adverse drug reactions (ADRs) has a significant impact on patients' quality of life, thorough knowledge about patients' perspectives on the burden of ADRs attributed to biologics is lacking.

Objectives: This study was conducted to gain insight into the patient burden of ADRs experienced with biologic use.

Methods: The Dutch Biologic Monitor is a prospective, multicentre, event monitoring cohort system including information collected by web-based questionnaires from patients using biologics, mainly for immune-mediated inflammatory diseases (IMIDs).

View Article and Find Full Text PDF

Objective: It is generally unknown how the attitudes and beliefs of health care professionals (HCPs) might affect the attitudes, beliefs, and medication-taking behavior of patients with rheumatoid arthritis (RA). This study aims 1) to examine the attitudes, health-related associations (both implicit and explicit), and beliefs of HCPs about conventional disease-modifying antirheumatic drugs, and 2) to assess whether these attitudes, health-related associations, and beliefs of HCPs are associated with those of their patients, with their patients' medication-taking behavior, and disease activity.

Methods: HCPs were recruited from 2 centers that specialized in rheumatology across The Netherlands, and patient recruitment followed.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to evaluate the quality of patient-reported medical information in the Dutch Biologic Monitor and assess the representativeness of participants involved in the research.
  • Data from 550 adult patients using biologic DMARDs were analyzed, revealing a 95.8% accuracy in reporting the correct medication and strong agreement with electronic health records, particularly for treatment indications and combination therapies.
  • The findings suggest that the Dutch Biologic Monitor is a reliable tool for collecting patient-reported information, as it aligns well with existing records and reflects the demographic characteristics of the broader population.
View Article and Find Full Text PDF

Objective: This study aims to explore the contribution of implicit attitudes and associations towards conventional disease-modifying antirheumatic drugs (cDMARDs), alongside explicit measures, on medication-taking behaviour and clinical outcomes in adult patients with rheumatoid arthritis (RA).

Methods: In this observational study, implicit attitudes (positive-negative) and health-related associations (health-sickness) were measured with Single Category Implicit Association Tests, whereas explicit outcomes were measured with a bipolar evaluative adjective scale and the Beliefs about Medicines Questionnaire Specific. The primary outcome of this study was medication-taking behaviour subjectively measured by self-report (i.

View Article and Find Full Text PDF

Background: Although patients have different treatment preferences, these individual preferences could often be grouped in subgroups with shared preferences. Knowledge of these subgroups as well as factors associated with subgroup membership supports health care professionals in the understanding of what matters to patients in clinical decision-making.

Objectives: To identify subgroups of patients with rheumatoid arthritis (RA) based on their shared preferences toward disease-modifying antirheumatic drugs (DMARDs), and to identify factors associated with subgroup membership.

View Article and Find Full Text PDF

Background: Folylpolyglutamate synthetase (FPGS) is a crucial enzyme in both cellular folate homeostasis and the intracellular retention of folate analogue drugs such as methotrexate (MTX), which is commonly used for the treatment of (pediatric) leukemia and the anchor drug in rheumatoid arthritis (RA) treatment. To date, assessment of FPGS catalytic activity relies on assays using radioactive substrates that are labor-intensive and require relatively large numbers of cells. Here, we describe a nonradioactive, ultra-high-performance liquid chromatography-tandem mass spectrometer (UHPLC-MS/MS)-based method allowing for sensitive and accurate measurements of FPGS activity in low cell numbers (ie, 1-2 × 10) of biological specimens, including leukemic blast cells of acute lymphoblastic leukemia patients and peripheral blood mononuclear cells of patients with RA.

View Article and Find Full Text PDF
Article Synopsis
  • * Out of 47 patients approached, 45 switched to Remsima, with 87% continuing treatment after 2 years, while a few restarted Remicade or switched to other medications due to effectiveness issues.
  • * Disease activity, measured by the DAS28-ESR score, remained stable before and after the switch, indicating no significant worsening in patient conditions.
View Article and Find Full Text PDF

Objectives: To determine the percentage non-adherence to etanercept in patients with rheumatoid arthritis during three years of follow-up.

Methods: During study visits in this prospective cohort study, blood samples were taken to determine serum etanercept concentrations using ELISA and patients were asked if they had missed an etanercept dose, at which date and for what reason. Non-adherence was defined as serum etanercept concentration <0.

View Article and Find Full Text PDF
Article Synopsis
  • * The OMERACT-Adherence study aims to establish a core set of outcome domains that can be consistently measured across various trials to better understand and improve medication adherence in rheumatology.
  • * The study includes five phases: a systematic review of existing outcomes, stakeholder interviews for insights, focus groups to rank important domains, a modified Delphi survey for broad input, and a workshop to finalize the core domain set.
View Article and Find Full Text PDF

What Is Known And Objective: Worldwide studies have shown that significant proportions of patients with type 2 diabetes (T2DM) do not meet targets for glycaemic control, blood pressure (BP) and lipids, putting them at higher risk of developing complications. However, little is known about medicines management in Australian primary care populations with T2DM. The aim of this study was to (i) describe the management of a large group of patients in primary care, (ii) identify areas for improvement in management and (iii) determine any relationship between adherence and glycaemic, BP and lipid control.

View Article and Find Full Text PDF