Patient‐reported outcomes following biologic therapy in a sample of adults with rheumatoid arthritis recruited from community‐based rheumatologists

• Published in: Arthritis and rheumatism 2009-05, Vol.61 (5), p.593-599
• Main Authors: Katz, Patricia, Yelin, Edward, Patel, Vaishali, Huang, Xing‐Yue, Chiou, Chiun‐Fang
• Format: Article
• Language: English
• Subjects: Aged; Antibodies, Monoclonal - therapeutic use; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - drug therapy; Cohort Studies; Community-Based Participatory Research; Etanercept; Female; Follow-Up Studies; Humans; Immunoglobulin G - therapeutic use; Infliximab; Interviews as Topic; Male; Middle Aged; Outcome Assessment (Health Care); Receptors, Tumor Necrosis Factor - therapeutic use; Severity of Illness Index; Treatment Outcome
• ISSN: 0004-3591; 0893-7524; 1529-0131; 1529-0123
• DOI: 10.1002/art.24511

Objective To examine self‐reported symptoms and functioning in a community‐based sample of persons with rheumatoid arthritis who did and did not initiate treatment with biologic agents. Methods Data were from annual telephone interviews (1998–2003) with an observational cohort identified through community rheumatologists. Self‐reported function and symptoms of subjects who initiated biologic therapy (etanercept or infliximab) and reported consistent use at 2 annual interviews (continuous use; n = 64) were compared at 1 year prior to initiation of therapy (baseline), and years 1 and 2 of therapy to those with no biologic therapy (n = 183) and those who initiated biologic therapy but discontinued use (n = 42). Results At baseline, subjects taking biologic agents reported significantly worse function and symptoms on all measures except fatigue and pain severity. After 2 years, significant differences in the Health Assessment Questionnaire scores remained, but there were no other significant differences between the nonuser group and the continuous use group. The discontinued use group exhibited significantly greater pain severity and more painful joints than nonusers. Improvements in the number of painful (33.4% versus 16.2%; P = 0.004), and swollen (38.4% versus 18.7%; P = 0.003) joints, and morning stiffness (27.3% versus 10.4%; P = 0.001) were more frequent in the continuous use group than in the nonuser group. Conclusion Results suggest that biologic treatment was initiated based on severe disease. Over ∼17 months of treatment, differences in some but not all symptoms between the continuous use group and the nonuser group narrowed to statistical nonsignificance.