The art of managing expectations: "Under-Promise and Over-Deliver"😊
● On efficacy: "It works quick and great for the majority, but some respond better to a different therapy. The test of the pudding is in the eating."
● On safety: "Side-effects are uncommon, but being aware, and with close monitoring, they can be managed."
● On convenience: "It's 2 infusions a year. " or "It's a painless monthly auto-injection" or "It's oral for easy storage and titration."...
● On cost: "Bite the bullet. 3 months as bridging/induction therapy for most, maybe 6 for some, or taper for maintenence if can't stop."
● On cure: "15-20% may be able to go off all drugs, if aggressively treated to full remission within 3 months from symptoms onset."
These are not glib sales talk. They are what I believe, how I practise, and typify the outcomes I achieve.
Disease activity guided dose reduction and withdrawal of adalimumab or etanercept compared with usual care in rheumatoid arthritis
Tapering or stopping biologics is more cost-effective than continuous usage, achievable in two-thirds of RA patients.