Background Psychological types of attitude to disease, or inner picture of disease, carefully describe the individual features of psychic reacting to somatic illness.1 Reports rarely reflect personality traits, to establish psychological response to rheumatoid arthritis (RA).2 No data are available regarding the influence of biologic therapy for RA patients on their peculiar psychological attitudes.
Objectives To assess psychological styles of reacting to RA in patients following B cell-directed therapy.
Methods Biologics-naïve RA patients were followed up for 27 months after commencing and continuing rituximab therapy (1, 2, 3 standard courses). The inner picture of disease was studied at baseline, 3, 15 and 27 months using the Lichko’s questionnaire.3
Results 86 patients [mean (SD) age 49.2 (15.3) years, 76 women; median (IQR) DAS28 5.64 (3.92–8.42); median (IQR) HAQ 1.85 (1.0–3.5)] were enrolled. The initial prevalence of disadaptive diffuse psychological type was 24.4%; during the follow-up of 27 months it disappeared (p for trend = 0.003). The incidence rates of two harmonic set components, harmonic (’sober assessment of self-condition’) and ergopathic styles (’move away from disease to work’), significantly increased over time.
Conclusions This study provides the first evidence that rituximab improves patients’ perception of rheumatoid arthritis. Within the limitations of a relatively small samples size and yet not controlled, the data suggest socio-psychological benefits from continued therapy with rituximab.
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Disclosure of Interest None Declared
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