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Treatment with the first TNF inhibitor in rheumatoid arthritis patients in the Hellenic Registry of Biologic Therapies improves quality of life especially in young patients with better baseline functional status

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13

  1. Department of Health Economics, National School of Public Health, Athens, Greece.
  2. Rheumatology, Clinical Immunology and Allergy, Medical School, University of Crete, Greece.
  3. Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
  4. Rheumatology Department, Sismanoglio Hospital, Athens, Greece.
  5. First Department of Internal Medicine, Rheumatology Section, AHEPA Hospital of the Aristotle University Medical School, Thessaloniki, Greece.
  6. Department of Rheumatology, 424 General Army Hospital, Thessaloniki, Greece.
  7. Department of Nutrition and Diebetics, Harokopio University, Athens, Greece.
  8. Rheumatology Clinic, General Hospital of Kavala, Greece.
  9. Department of Rheumatology, Veterans Administration Hospital, Athens, Greece.
  10. Department of Health Economics, National School of Public Health, Athens, Greece.
  11. Joint Academic Rheumatology Program, Faculty of Medicine, National and Kapodestrian University of Athens, Athens, Greece.
  12. Department of Health Economics, National School of Public Health, Athens, Greece.
  13. Rheumatology, Clinical Immunology and Allergy, Medical School, University of Crete, Greece. sidiropp@uoc.gr

CER9343 Submission on line
2016 Vol.34, N°6 - PI 0999, PF 1005
Full Papers

Rheumatology Article

 

Abstract

OBJECTIVES:
To assess in daily practice in patients with rheumatoid arthritis (RA) the effect of treatment with first tumour necrosis factor-α inhibitor (TNFi) in quality of life (Qol), disease activity and depict possible baseline predictors for gains in Qol.
METHODS:
Patients followed prospectively by the Hellenic Registry of Biologic Therapies were analysed. Demographics were recorded at baseline, while RA-related characteristics at baseline and every 6 months. Paired t-tests were used to detect divergences between patient-reported (Health Assessment Questionnaire (HAQ), EuroQol (EQ-5D)) and clinical tools (Disease Activity Score-28 joints (DAS28)). Clinical versus self-reported outcomes were examined via cross-tabulation analysis. Multiple regression analysis was performed for identifying baseline predictors of improvements in QALYs.
RESULTS:
We analysed 255 patients (age (mean±SD) 57.1±13.0, disease duration 9.2±9.1 years, prior non-biologic disease-modifying anti-rheumatic drugs 2.3±1.2). Baseline EQ-5D, HAQ and DAS28 were 0.36 (0.28), 1.01 (0.72) and 5.9 (1.3), respectively, and were all significantly improved after 12 months (0.77 (0.35), 0.50 (0.66), 3.9 (1.5), respectively, p<0.05 for all). 90% of patients who improved from high to a lower DAS28 status (low-remission or moderate) had clinically important improvement in Qol (phi-coefficient=0.531,p<0.05). Independent predictors of gains in Qol were lower baseline HAQ, VAS global and younger age (adjusted R2=0.27).
CONCLUSIONS:
In daily practice TNFi improve both disease activity and Qol for the first 12 months of therapy. 90% of patients who improved from high to a lower DAS28 status had clinically important improvement in Qol. Younger patients starting with lower HAQ and VAS global are more likely to benefit.

PMID: 27749220 [PubMed]

Received: 15/02/2016 - Accepted : 07/03/2016 - In Press: 07/10/2016 - Published: 28/11/2016