Final published version
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Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Biological therapy in patients with rheumatoid arthritis in a tertiary center in portugal
T2 - A cross-sectional study
AU - FERNANDES, Melissa
AU - FIGUEIREDO, Adelaide
AU - OLIVEIRA, Ana Luísa
AU - FERREIRA, Ana Carolina
AU - MENDONÇA, Pedro
AU - TAULAIGO, Anna V.
AU - VICENTE, Madalena
AU - FANICA, Maria João
AU - RUANO, Carina
AU - PANARRA, António
AU - MATEUS, Céu
AU - MORAES-FONTES, Maria Francisca
PY - 2021/5/31
Y1 - 2021/5/31
N2 - Introduction: Clinical outcomes in rheumatoid arthritis have greatly improved with therapeutic advances. Despite the availability of substantial clinical trial evidence, there is a lack of real-life data. The aim of this study was to assess disease status and quality of life in an outpatient population treated with biological disease-modifying anti-rheumatic drugs. Material and Methods: Cross-sectional study recalling all patients ever treated in our unit with biological disease-modifying anti-rheumatic drugs. Clinical and demographic data, compliance, disease activity, functional status, joint deformities, and comorbidities were documented, and patients queried on occupational status, education, marital status and generic health related quality of life questionnaires. Results: Recall was attended by 77 of the original 94 patients. At recall, median age was 63 years old, 82% of the patients were female and the median disease duration was 12 years. Biological therapy was started at a median of four years following disease onset. According to the disease activity score (DAS28), the percentage of patients with high, moderate, low disease activity or remission changed from 50, 45, 0 and 5 (pre-therapy) to 11, 37, 25 and 26 at recall, respectively; functional status was significantly improved. Seventy-five per cent of the patients retained the original treatment with good compliance. Lower Short Form-36 domain scores accompanied a low EQ-5D-3L score. Deceased patients (n = 6) had a lower estimated 10-year survival rate. In this group, biological therapy was discontinued at a higher frequency during follow-up. Discussion: A high disease activity and a high HAQ disability index characterized most patients at pre-bDMARD onset. Conclusion: Despite therapy switches and regular follow-up, a significant percentage of patients still presented with moderate disease activity, functional impairment and a poor health-related quality of life.
AB - Introduction: Clinical outcomes in rheumatoid arthritis have greatly improved with therapeutic advances. Despite the availability of substantial clinical trial evidence, there is a lack of real-life data. The aim of this study was to assess disease status and quality of life in an outpatient population treated with biological disease-modifying anti-rheumatic drugs. Material and Methods: Cross-sectional study recalling all patients ever treated in our unit with biological disease-modifying anti-rheumatic drugs. Clinical and demographic data, compliance, disease activity, functional status, joint deformities, and comorbidities were documented, and patients queried on occupational status, education, marital status and generic health related quality of life questionnaires. Results: Recall was attended by 77 of the original 94 patients. At recall, median age was 63 years old, 82% of the patients were female and the median disease duration was 12 years. Biological therapy was started at a median of four years following disease onset. According to the disease activity score (DAS28), the percentage of patients with high, moderate, low disease activity or remission changed from 50, 45, 0 and 5 (pre-therapy) to 11, 37, 25 and 26 at recall, respectively; functional status was significantly improved. Seventy-five per cent of the patients retained the original treatment with good compliance. Lower Short Form-36 domain scores accompanied a low EQ-5D-3L score. Deceased patients (n = 6) had a lower estimated 10-year survival rate. In this group, biological therapy was discontinued at a higher frequency during follow-up. Discussion: A high disease activity and a high HAQ disability index characterized most patients at pre-bDMARD onset. Conclusion: Despite therapy switches and regular follow-up, a significant percentage of patients still presented with moderate disease activity, functional impairment and a poor health-related quality of life.
KW - Arthritis
KW - Biological Products/therapeutic use
KW - Biological Therapy
KW - Quality of Life
KW - Rheumatoid/drug therapy
U2 - 10.20344/AMP.13605
DO - 10.20344/AMP.13605
M3 - Journal article
C2 - 33566755
AN - SCOPUS:85102046671
VL - 34
SP - 362
EP - 371
JO - Acta Medica Portuguesa
JF - Acta Medica Portuguesa
SN - 0870-399X
IS - 5
ER -