Background According to the T2T recommendation, the primary target in the treatment of rheumatoid arthritis (RA) is to achieve the state of clinical remission, and the desired treatment target should be maintained throughout the remaining course of the disease.1) To date, reports have been published on cases where clinical remission was maintained with the use of biologicals, etc.,2) but there have been few reports published on cases where QOL of the patients was maintained as well.
Objectives The present study was designed to evaluate whether or not QOL was maintained in patients with RA remaining in the state of clinical remission or low disease activity, using AIMS-2 (Arthritis Impact Measurement Scales version 2) as a tool for QOL evaluation.
Methods The investigation using AIMS-2 was carried out between May and August in 2011 and 2012, involving patients with RA remaining in the state of clinical remission or low disease activity while receiving treatment with biologicals at our clinic.
Results Cooperation with the investigation for the 2-year period was obtained from 153 RA patients. The biological preparations used were etanercept (62 cases), infliximab (39 cases), tocilizumab (21 cases), abatacept (16 cases), adalimumab (14 cases) and golimumab (1 case). The mean score of each AIMS-2 item in 2012 differed little from that in 2011, allowing us to confirm that QOL was also maintained in these patients. The score for pain, which is one of the factors known to markedly reduce QOL, improved from 9.8 to 9.0, and this was the only parameter showing a significant difference between the years 2011 and 2012 (P=0.002).(Table)
Conclusions The results of this investigation allowed us to confirm that QOL was also maintained in patients with RA in whom treatment with biologicals maintained the state of clinical remission or low disease activity for a long period of time. According to the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis, nurses should participate in comprehensive disease management to control disease activity, to reduce symptoms and to improve patient-preferred outcomes.3) We believe that one of the approaches possibly contributing to long-term maintenance of QOL is that nurses proactively participate in QOL assessment with AIMS-2, etc. and to have close contact with individual RA patients; to facilitate early detection of abnormalities and changes in responses to treatment and to take early countermeasures on the basis of these findings.
Josef S Smolen, et al. Ann Rheum Dis 2010;69:631-637
Josef S Smolen, et al. Ann Rheum Dis 2012;71(Suppl3):367
Yvonne van Eijl-Hustings, et al. Ann Rheum Dis 2012;71:13-19
Disclosure of Interest None Declared