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Clinicians may use bDMARDs
(Biological Disease-Modifying Anti-Rheumatic Drugs) to improve QoL (quality of life) in patients with rheumatic diseases.
A recent study illustrated that following treatment with bDMARDs, patients with RA (rheumatoid arthritis), AS (ankylosing spondylitis) and PsA (psoriatic arthritis) displayed considerably better QoL levels.
A prospective, single-center, observational cohort study was conducted in Brazil to explore the association between DMARDs use and QoL in patients with RA, AS, and PsA. The study recruited 595 adult patients prescribed bDMARDs.
The primary endpoint was the estimation of EQ-5D (EuroQol 5 dimensions) QoL after six and 12 months of bDMARDS. Regardless of the rheumatic disease and the therapeutic regimen (bDMARDs as monotherapy vs bDMARDs plus synthetic DMARDs as combination therapy), a significant clinical improvement was witnessed in QoL after six and 12 months in patients treated with bDMARDs.
Overall, 62.6% of the participants displayed remarkable clinical improvement in QoL at the end of one year. The results of QoL in the multiple imputation model and the complete case analysis illustrated similar conclusions according to a sensitivity analysis. At 12-month follow-up, the presence of comorbidities, functional disability (HAQ-DI, Health Assessment Questionnaire – Disability Index) and baseline quality of life are predictors of EQ-5D response.
In comparison to subjects having better disability status on the baseline, worse QoL was presented at 12 months in individuals having two or more comorbidities, worse QoL, and disability status on the baseline. After 12 months of bDMARD treatment, baseline clinical disease estimated by activity indexes (BASDAI, Bath Ankylosing Spondylitis Disease Activity Index and CDAI, Clinical Disease Activity Index) did not influence QoL.
At six and 12 months, patients attained improvements in all EQ-5D domains. The EQ-5D domain that significantly affected QoL was malaise and pain as shown in following Figure;
Thus,
in patients with rheumatic diseases, bDMARDs can effectively enhance QoL.
Hospital Practice
Impact of biologic DMARDs on quality of life: 12-month results of a rheumatic diseases cohort using the Brazilian EQ-5D tariff
Haliton Alves de Oliveira Junior et al.
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