PharmARC SMMA Insights About Rheumatoid Arthritis from Twitter Data

PharmARC SMMA
Insights from Social Media Data
Jan 2011 to July 2011 – Twitter data for rheumatoid arthritis

Tanmay Saraykar
Manager, Social Media Analytics www.pharmarc.com

Every Sunday, RA patients chat on Twitter using #rheum on
various topics related to rheumatoid arthritis

Daily count of tweets – Jan 2011 to July 2011
600

Sunday, March 06, Sunday, July 24, 2011
500 2011

400

Sunday, January 09, Sunday, June 05, 2011
2011
300
Sunday, January 30, Sunday, April 17, 2011
2011
200

100

0

© PharmARC Analytic Solutions Pvt. Ltd., 2011. All Rights Reserved. Slide 2

RA Activities on Twitter – Overview

Twitter hashtag Definition: Words or phrases prefixed with a # sign,
used as text indicators to organize around an idea, tweet about certain
subjects, group posts around topics

Popular Twitter hashtag for rheumatoid arthritis: #rheum
#rheum - Chats on Rheumatology topics:
Sundays at 3pm EST/8pm GMT. Use the
hashtag #rheum for rheumatology tweets

This hashtag is a Tweet Chat

Duration: January 2, 2011 to July 31, 2011
Total no. of tweets using #rheum – 16,524
Total tweeting accounts – 1160
No. of tweets for top 10% accounts – 13,049
(80%)

Top 10 % accounts are the most influential.


Sample tweets from patients of rheumatoid arthritis

mouth sores from #Rheum doc appt
So far I've been on
Methotrexate went well. Switching to
Plaquenil, MTX, commented on
#rheum // if folic injection & upping
Arava and Enbrel. your Humira post;
acid doesn't work, dose of Methotrexate.
My rheumy has I had no luck with
try folinic acid. A Go back in 2mths; 2
now prescribed it either, but
rhubarb extract consider Remicade in
Humira. #rheum Rituximab has
may help healing. place of Enbrel.
changed my life,
so there is hope
#rheum

MTX: 3 years, Uggity.
Rituximab: 3 years, Painsomnia stinks.
Perfect post today. I
Prednisolone: 6 Been up 5 hrs
have PsA and P Enbrel works for
years. Tried after sleep for 3.
#rheum just put me me! Humira gave
everything from This is gonna be a
on Methotrexate me headache all
Anti-TNF to JOY of a day. And
recently since my day everyday for
plaquenil in- Enbrel delivery!
Enbrel stopped entire 2 mos. I
between #rheum #rheum
working. Need used it. #rheum
positives.


Chat Topics – January 2011
(Sundays – 2nd, 9th, 16th, 23rd and 30th)
Chat Topics from Chats on Twitter with #rheum Standard Twitter Chat Rules
1. How many RA patients manage to work full time, part time? For 1. Tweets assumed to be your
how many years? How about working from home? own opinion
2. Do not sell
2. New year resolutions for RA patients 3. Politely stay on topics
3. Patients bringing in information about RA, does it bother
doctors? What about writing to doctors or commenting on blogs? Social Essence

4. Favorite stress relievers for patients, rewards and comforts 1. Professional life of RA
patients
5. Do you do what the doctor says? If not, do you tell the doctor? 2. Pain management
3. Stress relief and hobbies
6. Are online support groups better than local support groups?
4. Compliance to prescription
Why? drugs
7. Annual RA meet-up 5. Social information sharing
and support groups
8. Depression from chronic pain 6. Annual events
• Suggestions to avoid or combat depression 7. Emotional issues related to
chronic pain from RA
• What can friends, family members, doctor do to help 8. Helping newly diagnosed
depression from chronic pain? patients
9. Most important suggestions to patients newly
diagnosed with RA


Social media data reveals valuable insights about
critical parameters of prescription drugs

 Drug consumption/Comments
about Drug Brands
The insights
revealed through  Drug efficacy, Side effects
social media
monitoring and  Switch-overs
analysis can act
as decision-  Combination with other medication
making points for
consumers  Convenience of dosage


Social media reveals – Drug Consumption data for
various drug classes

#1 Drug consumption

Which prescription drugs are being consumed by patients of rheumatoid
arthritis?

Drug Class Brands
 DMARDs Enbrel, Humira,
 Biologics Remicade, Rituxan,
 NSAIDs Orencia, Actemra,
Cimzia, Simponi, etc.


Analysis of tweets reveals buzz around rheumatoid
arthritis brand names – Tag clouds for brand names

Methotrexate
Orencia

Enbrel
Cimzia
Simponi

Rituxan

Remicade

Humira
Actemra


Methotrexate is by far the most discussed, amongst
drugs (not surprising)

Total Mentions

Methotrexate 517

Enbrel (etanercept) 226

Humira (adalimumab) 189

Remicade (infliximab) 86

Orencia (abatacept) 54

Actemra (tocilizumab) 50

Rituxan (Rituximab) 45

Simponi (golimumab) 22

Cimzia (certolizumab) 11

0 100 200 300 400 500 600


Social media reveals – Comments about efficacy
of drugs

#2 Drug efficacy and Side effects

Which prescription drugs work better than others? How do drugs compare on
efficacy as mentioned by patients?

Efficacy

 Biologics - Half life of the drug
 Positive efficacy
 Negative efficacy


Tweets by patients of rheumatoid arthritis reveal
insights regarding efficacy of biologics

25
22

20
18

15

10 9 9

5
3 3
2 2 2 2
0 0
0
Enbrel

Remicade
Humira

Orencia

Actemra

Rituxan
Drug works for me Doesn’t work/worsened condition


Social media data contains patients’ comments about side
effects of various drugs (methotrexate example)

Side effects of methotrexate from Twitter data
12

10 10
10
9

8

6 6
6

4
4
3 3
2 2 2 2 2
2

0
Fatigue

Nausea

Vomiting

Fever
Stomach Ache/Issues

Sickness

Flares

Insomnia
Bizzare dreams

Abdominal cramps
Hair loss/thinning hair

Breathing difficulty

Allergic reaction

Side effects of various biologics as mentioned by the
patients who are consuming them
Side effects - Enbrel Side effects - Humira Side effects - Rituxan
 Cough/Chronic respiratory  Flu like symptoms
infection  Burning sensation (2)
 Painsomnia  Lowers ability to fight infection  Sickness (1)
 Joint and muscle pain (3)  Upper respiratory problems
 Burning sensation (2)  Headache (2)
 Fatigue  Nerve shock and numbness?
 Flares (2)  Lupus like and MS like symptoms

 Fever  Inflammation

 Gastrointestinal symptoms  Sickness

 Thinning hair  Excessive was build-up in ears
(3)
 Nausea
 Flares (2)
 Paleness
 Lightheadedness, hot flashings,
 Mouth sores (2) chills
 Fever
 Rashes and bruising


Side effects of various biologics as mentioned by the
patients who are consuming them
Side effects - Remicade Side effects - Orencia Side effects - Actemra

 Hangover  Cough (4, with one  Hives (2)
 Headache (2) mentioning persistent, severe  Allergic reaction (1)
 Ill feeling, fatigue cough)
 Allergic reaction (3)
 Queasy and crackly feeling
 Drop in blood pressure
 Itch and bruises


Social media reveals – comments on switch-overs

#3 Drug switch-overs

When one biologic drug or DMARD stops working for an RA patient, which
one do they switch to?

Switch-overs
 Reasons for
switching drug class
 Reasons for
switching brands
within a drug class


For patients of rheumatoid arthritis, social media data reveals switch-
overs from one drug class to another (From DMARDs to Biologics) as
well as within a certain drug class (within biologics)

Switchover to Enbrel from Switchover from Enbrel to

Methotrexate

Methotrexate 1
3
5 Humira
Humira 1

1 2

Orencia Remicade
2 1

Unspecified Unspecified


Summary of switch-overs between RA brands (38) –
Combining insights from all social media platforms should
reveal substantial insights (example below is from twitter)


Analysis of 38 switch-overs mentioned in tweets indicate
that efficacy is a significant reason for switch over

Helps with
other
Side effect indication
5% 3%
Previous drug
stops working
24%

Not specified
68%


Social media reveals – what drug combinations the
patients are on

#4 Drug combinations

For treatment of RA, which combinations of drugs are taken by patients?

Switch-overs
 DMARDs and
Biologics
 NSAIDs and Pain
Killers
 Anti-depressants


Methotrexate is used in combination with various
biologics for treatment of rheumatoid arthritis

Combinations of methotrexate with biologics

MTX and Enbrel 18
NSAIDs/Pain
Killers/Others
MTX and Humira 12
 Sulfasalazine
 Prednisone
MTX and Orencia 3
 Mobic
 Ibuprofen
MTX and Rituximab 2
 Naproxen
 Anti-acidity
MTX and Cimzia 1
 Anti-depressant
 Folic Acid
MTX and Actemra 1

0 5 10 15 20


Social media reveals – comments on convenience
of dosage for RA drugs

#5 Convenience of dosage

What are the issues associated with administering biologics to RA patients?

Convenience

 DMARDs
 Biologics


RA patients post comments about convenience of dosage for
DMARDs and biologic drugs
DMARD - methotrexate Biologic - Enbrel

Positives Negatives Positives Negatives

 Methotrexate stays  Methotrexate takes  Enbrel can sustain  Often causes
longer in the body time to become in good condition swelling at the
 Methotrexate active in the body for 4 days at room injection site
injections cause  Methotrexate oral temperature, easy  If injected in the
less stomach medication causes to carry during stomach, leaves
problems nausea travel bruises
 Patients need to
put ice at the
injection site which
is inconvenient
 Doesn’t stay for
long in the body
 Needed in more
volumes and
frequent injections


Trends from social media data - Conversations about rheumatoid
arthritis on social media platforms revolve around three main topics
Drugs/Brands for treating RA Pain/inflammation management Emotional issues

• Parameters of RA drugs • Patients discuss the drugs • Patients show strong
(such as DMARDs and consumed for managing empathy and concern on
Biologics), on the basis of chronic pain and social networks about
which, patients take inflammation such as fellow RA patients
decisions, e.g. NSAIDs and pain killers • They encourage sharing
• Efficacy • Discussions around issues relating to family,
• Side effects household therapies and livelihood, friends,
• Switch-overs alternative therapies for important events (e.g.
• Convenience of relieving pain undergoing some surgery,
dosage • Patients share tips for pregnancy, etc.) to gain
• Costs managing the emotional and social
• Discussions around inconvenience during support
reasons for switching over biologic infusions • RA patients express
between drug classes as • Patients share information depression due to chronic
well as switching brands about precautions to be pain and immobility as a
within a drug class taken against major concern
• Discussions around pain/inflammation during
medication and alternative different seasons, as
therapies needed to treat severe weather conditions
the side effects of RA may elevate RA-related
drugs symptoms


Conclusion

Continuous monitoring and analysis of healthcare-related social
media data reveals insights into critical aspects of prescription
drugs, and helps understand the consumers better


For further information on this document, please contact:

Tanmay Saraykar
Manager, Social Media Analytics
+91 7829909766
tanmay.saraykar@pharmarc.com

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© PharmARC Analytic Solutions Pvt. Ltd., 2011. All Rights Reserved.

PharmARC SMMA Insights About Rheumatoid Arthritis from Twitter Data

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PharmARC SMMA Insights About Rheumatoid Arthritis from Twitter Data