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Prompt antiviral treatment after an influenza diagnosis reduced the use of health care costs and resources among people with rheumatoid arthritis (RA).

That's according to recent findings published in .

The study included 2,638 people who received antiviral influenza treatment within two days of flu diagnosis and 1,319 patients who did not. For treated versus untreated patients, the respective mean numbers of all-cause outpatient visits were 0.96 versus 1.21 during 14 days of follow-up (P<0.001) and 1.94 versus 2.24 over 28 days of follow-up (P=0.001). Further, over 28 days the mean number of all-cause emergency department visits was lower among treated (0.23) versus untreated (0.30) patients (P=0.042). The mean number of respiratory-related outpatient visits was significantly lower for treated versus untreated patients, and mean costs for these visits were $17.89 versus $35.27 over 14 days.

Co-author Arpamas Seetasith, PhD, is a senior health economist with Genentech, a American biotechnology corporation and subsidiary of drug manufacturer Roche. She recently discussed the study and its findings with the Reading Room. The exchange has been edited for length and clarity.

What key question was this study designed to address?

Seetasith: Our study was designed to understand the burden of flu, as well as the real-world impact of antivirals, on health care utilization in patients with RA, using a large U.S. administrative claims database. It addresses the question of whether patients with RA who contract the flu and who take antiviral medication within 48 hours of illness onset have fewer influenza-related complications and incur lower overall health care resource use and cost.

We believe this is an important topic as the clinical and economic burden of influenza in individuals with RA is thought to be disproportionately high, given that RA patients face an increased risk of developing influenza due to their immunocompromised system.

How would you summarize your key findings?

Seetasith: The proportion of patients who needed at least one visit to an emergency department over the 28 days after contracting influenza was significantly higher among those not treated with antiviral medications than among those who were treated (8.8% vs. 6.5%). We also found untreated patients utilized more than 1.5-fold more respiratory-related outpatient medical services than treated patients.

Lastly, in the untreated group, all-cause costs related to inpatient admission were 1.4 times higher and costs for emergency department visits were 1.9 times higher.

Did anything surprise you about the study or its results?

Seetasith: Despite existing evidence showing more than a two-fold higher risk of serious complications from influenza in RA patients compared with those without RA, we were surprised to learn that fewer than two-thirds of RA patients who received medical attention for influenza in an outpatient setting were treated with an antiviral medication.

Although many clinicians prescribe antiviral treatment, we didn't expect that a considerable population of high-risk patients hadn't received antiviral treatment.

How might you advise clinicians and practices in light of these results?

Seetasith: Our study demonstrated that patients with RA who contract influenza and receive antiviral therapy can reduce influenza-related complications and the need for emergency department visits or hospitalization. We would advise clinicians to continue to educate their patients on the seriousness of flu, the importance of vaccination, and the need to seek care promptly after they become ill with influenza, based on empirical evidence that shows the benefits of antiviral treatment within 48 hours of their symptom onset.

Clinical implications

• Patients with RA who received antiviral treatment within 48 hours of contracting influenza required fewer health care resources, including emergency department visits or hospitalization.
• A significant number of RA patients who develop the flu do not receive antivirals quickly or at all.
• The study also highlights the need educate RA patients on the seriousness of the flu and the importance of vaccination.

Read the study here and expert commentary on the clinical implications here.