• Melissa Fernandes, Adelaide Figueiredo, Ana Luísa Oliveira, Ana Carolina Ferreira, Pedro Mendonça, Anna V Taulaigo, Madalena Vicente, Maria João Fanica, Carina Ruano, António Panarra, Céu Mateus, and Maria Francisca Moraes-Fontes.
• Unidade de Doenças Auto-imunes/Medicina 7.2. Hospital de Curry Cabral. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Portugal.
• Acta Medica Port. 2021 May 2; 34 (5): 362-371.

IntroductionClinical 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 MethodsCross-sectional study recalling all patients ever treated in our unit with biological disease-modifying antirheumatic 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.ResultsRecall 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.DiscussionA high disease activity and a high HAQ disability index characterized most patients at pre-bDMARD onset.ConclusionDespite 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.

19 keywords...

hide…