Background Chronic inflammatory arthropaties-CIA (RA-rheumatoid arthritis, PA-psoriatic arthritis, and AS-ankylosing spondylitis) cause functional disability and reduces health-related quality of life (HRQoL) of patients1
Objectives To evaluate HRQoL in patients with CIA and biologic therapy (BT), as a measure of patient reported outcome.
Methods Descriptive cross-sectional study (August 2014) in a tertiary hospital. Inclusion criteria:a)adult patients with RA, PA, SA and other CIA (O) attended at the Rheumatology Service and b)≥2 months of treatment with BT (sc/iv adalimumab-ADA, sc/iv etanercept-ETA, iv infliximab, sc golimumab, sc certolizumab, sc/iv abatacept, sc/iv tocilizumab or iv rituximab). Sociodemographic and clinical variables were obtained by structured interview and review of medical record.Degree of disease activity measures: DAS28 index (≤3.2:low activity; >3.2-≤5.1:moderate; >5.1:high) for RA and PA peripheral; BASDAI (<4:low activity ≥4:high activity) for AS and PA with predominant axial involvement. HRQoL was mesured by a self-administered questionnaire:EQ5D-5L2. It evaluates 5 dimensions:mobility (M), self-care, usual activities (UA)pain/discomfort (PD) and anxiety/depression. Each dimension has 5 levels of severity. A HRQoL score is obtained (EQ-index) from 0 (death) to 1 (full health). It also has a visual scale (EQ-VAS) of global health from 0 (the worst health) to 100 (the best health). Descriptive and multiple linear regression analysis (LRA) were performed to determine which variables contributed on HRQoL.
Results A total of 382 patients were eligible for the study.314 patients agreed to answer the questionnaire (women:55.7%, average age (±SD): 55.2±13.9 years, average disease duration (±SD):13.05±8.1 years). Pathologies distribution: 44.3% RA, PA 26.1%, 21.3% AS, 8.3% O. BT: 51.9% ADA, 28.7% ETA and 19.4% others. 65.9% of patients had a first line of TB. 50% of patients had concomitant drug (corticosteroid/methotrexate/leflunomide). 71.7% of patients had low activity, with standard drug regimen (61.8%) and optimized regimen (37.6%). The EQ-index perceived was:0.73±0.22 and a global health EQ-VAS: 64.2±21.0 points. The worst rated questionnaire dimensions (severities 3–4-5) were P (33.7%), UA (29.9%) and M (26.7%).
LRA showed significance differences (p<0.001) for disease activity, disease duration and education. 0.4 and 9.05 EQ-VAS points were reduced for each year of evolution and each DAS28 point increase, respectively. Differences were not significant for age, sex, pathology, drug or line number.
Conclusions Generally, patients evaluated have a good control of disease activity and an acceptable HRQoL perceived. Chronic P and loss of autonomy to perform UA are the worst rated dimensions
Gerhold K, Richter A, Schneider M, Bergerhausen HJ, Demary W, Liebhaber A, et al. Heailth-related quality of life in patients with long-standing rheumatoid arthritis in the era of biologics: data from the German biologics register RABBIT. Rheumatology.2015; 54:1858–66.
Rabin R, de Charro F. EQ-5D:a measure of health status from the EuroQol Group. Annals of Medicine. 2001; 33:337–43
Disclosure of Interest M. Άlvarez-Payero: None declared, F. Maceiras: None declared, R. Melero: None declared, C. Mouriño: None declared, A. Martin: None declared, M. Rodríguez-Rodríguez: None declared, M. Ucha: None declared, N. Martínez: None declared, I. Hernandez: None declared, C. Barbazán: None declared, M. Rodríguez: None declared, V. Balboa: None declared, J. Uña: None declared, G. Piñeiro Grant/research support from: Pfizer, J. Pego Grant/research support from: Pfizer