Objectives We examined the factors that led to health assessment questionnaire (HAQ) remission after beginning biologics treatment in patients with rheumatoid arthritis (RA)
Methods A total of 107 RA patients were assessed prior to treatment and 30 weeks after therapy initiation. The subjects were treated as follows: infliximab, 47 patients; etanercept, 17 patients; adalimumab, 25 patients; and tocilizumab, 18 patients. The age, gender, steroid dosage, methotrexate (MTX) dosage, disease activity (DAS28) score, health-related quality of life (HRQoL) questionnaire scores (modified health assessment questionnaire (mHAQ) and Short Form (SF)-36) and depression scale scores (Japanese version of the structured interview guide for the Hamilton Depression rating scale (HAM-D) and the Self-rating Depression Scale (SDS)) were assessed before initiating biologics treatment. HAQ remission was defined as a score less than 0.5 point after 30 weeks without evaluating clinical and structural remission.
Results The HAQ remission group was characterized by younger age (57.8±14.8 vs. 66.8±13.2 years, p=0.005), lower steroid dosages (3.3±3.3 vs. 5.1±3.2 mg per day, p=0.011), higher MTX dosages (8.3±4.0 vs. 6.7±3.7 mg per week, p=0.028) and lower DAS28 scores (4.7±1.3 vs. 5.3±1.4) compared with the no-HAQ-remission group before treatment. In addition, the group had lower HAQ scores (0.32±0.36 vs. 1.1±0.36, p<0.001), higher SF-36 scores (all 8 categories, p<0.01), lower SDS scores (39.8±9.0 vs. 43.8±10.5 points, p=0.029) and lower HAM-D scores (5.1±3.5 vs. 7.8±4.9 point, p=0.005) before treatment and high drug efficacy (p=0.044) compared with the no-HAQ-remission group. In particular, younger age (less than 70 years old, odds ratio: 0.29), lower steroid dosages (less than 5 mg prednisolone per day, odds ratio: 2.87), lower HAQ scores (less than 0.5 point, odds ratio: 52.31) and lower HAM-D scores (less than 7 points, odds ratio: 3.00) were important factors for HAQ remission. However, there was no significant difference in gender between the 2 groups.
Conclusions Younger age, lower steroid dosages, higher QOL scores and lower depression scores are the important factors for HAQ remission with RA patients who undergo biologics treatment.
Disclosure of Interest None Declared