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Comparative Study
. 2015 Oct;54(10):1858-66.
doi: 10.1093/rheumatology/kev194. Epub 2015 May 21.

Health-related quality of life in patients with long-standing rheumatoid arthritis in the era of biologics: data from the German biologics register RABBIT

Kerstin Gerhold  1 , Adrian Richter  2 , Matthias Schneider  3 , Hans-Joachim Bergerhausen  4 , Winfried Demary  5 , Anke Liebhaber  6 , Joachim Listing  7 , Angela Zink  8 , Anja Strangfeld  7
Affiliations
Comparative Study

Health-related quality of life in patients with long-standing rheumatoid arthritis in the era of biologics: data from the German biologics register RABBIT

Kerstin Gerhold et al. Rheumatology (Oxford). 2015 Oct.

Abstract

Objective: To compare the 24-month course of health-related quality of life (HRQoL) in patients with long-standing RA treated with a conventional synthetic (cs) or a first, second or third biologic (b) DMARD in daily rheumatological care.

Methods: Patients enrolled in the German biologics register RABBIT who were observed over at least 12 months were stratified according to the nth bDMARD started at enrolment. HRQoL was captured by the SF36 health survey. Within strata of sequential bDMARD therapy, we examined patients' HRQoL at baseline and at follow-ups in comparison with the general population, the 24-month course of HRQoL of different bDMARDs and the proportion of patients exceeding the minimal detectable improvement of physical and mental health sum scores.

Results: All patients reported remarkably lower scores of physical and mental health than the general population at baseline and month 12. In each stratum of sequential bDMARD therapy, patients improved significantly by month 12 and remained stable until month 24. The improvement of HRQoL was not attributable to a particular bDMARD. The following proportions of patients exceeded the minimal detectable improvement of at least 17.85 Physical Component Scale scores or 22.18 Mental Component Scale score points: csDMARD (n = 1113) 31.1%/22.3%, first bDMARD (n = 1352) 39.9%/29.7%, second bDMARD (n = 730) 37.3%/26.2% and third bDMARD (n = 680) 34.2%/30.9%.

Conclusion: Lasting improvement of both physical and mental health is achievable even for severely affected RA patients with a history of more than one bDMARD failure. Nevertheless, impairment of HRQoL in RA patients is enormous compared with the general population.

Keywords: biologics register; health-related quality of life; minimal detectable change; rheumatoid arthritis.

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Figures

F<sc>ig</sc>. 1
Fig. 1
RABBIT patients included in the present analysis bDMARD: biologic DMARD; csDMARD: conventional synthetic DMARD; not available: patients with a regular observation time of <24 months.
F<sc>ig</sc>. 2
Fig. 2
Health-related quality of life of RA patients in context with the German general population bDMARD: biologic DMARD; BP: bodily pain; csDMARD: conventional synthetic DMARD; GH: global health; MH: mental health; PF: physical functioning; RE: role emotional; RP: role physical; SF: social functioning; V: vitality.
F<sc>ig</sc>. 3
Fig. 3
Average 24-month scores of the physical component scale of each stratum of sequential DMARD therapy bDMARD: biologic DMARD; csDMARD: conventional synthetic DMARD; PCS: physical component scale.
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