Skip to main content
Erschienen in: Clinical Rheumatology 2/2018

06.01.2018 | Original Article

Health-related quality of life outcomes in patients with rheumatoid arthritis and ankylosing spondylitis after tapering biologic treatment

verfasst von: Ming-Han Chen, Mei-Hsuan Lee, Hsien-Tzung Liao, Wei-Sheng Chen, Chien-Chih Lai, Chang-Youh Tsai

Erschienen in: Clinical Rheumatology | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

Treatment with biological disease-modifying anti-rheumatic drugs (bDMARDs) for rheumatoid arthritis (RA) and ankylosing spondylitis (AS) is popular. The aim of this study was to investigate changes in the quality of life (QoL) in patients after receiving, tapering, or stopping bDMARD treatment. Three hundred and thirty patients with RA and 120 patients with AS were enrolled. Data on the patients receiving bDMARDs were obtained by self-completed questionnaires including the short-form 36 (SF-36) and Global Quality of Life (GQL) scale. A relapse was defined as the QoL becoming worse than that before bDMARD treatment. Significant improvement in all domains of the SF-36 and GQL was noted in the patients after receiving bDMARDs. Improvement in SF-36 was significantly greater in RA patients with a shorter disease duration (< 6 years) and milder patient-assessed disease activity and in AS patients with a shorter disease duration and younger age. There were significant decreases in all domains of the SF-36 and GQL in both groups after reducing/discontinuing bDMARD treatment. The patients in both groups with a shorter period of bDMARD treatment (≤ 3 years) had significantly worse SF-36 scores compared to those with a longer period of bDMARD treatment (> 3 years). The relapse rate after reducing/discontinuing treatment was over 90.0% in the RA patients and over 50.0% in the AS patients within 12 months. bDMARDs significantly improved the QoL of the patients with RA and AS. However, interrupting or stopping the treatment protocol worsened the QoL and led to relapses, especially in the patients who used bDMARDs for a shorter period.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Graudal N (2004) The natural history and prognosis of rheumatoid arthritis: association of radiographic outcome with process variables, joint motion and immune proteins. Scand J Rheumatol Suppl 118:1–38CrossRefPubMed Graudal N (2004) The natural history and prognosis of rheumatoid arthritis: association of radiographic outcome with process variables, joint motion and immune proteins. Scand J Rheumatol Suppl 118:1–38CrossRefPubMed
3.
Zurück zum Zitat Koh ET, Leong KP, Tsou IY, Lim VH, Pong LY, Chong SY, Seow A, Tan Tock Seng Hospital Rheumatoid Arthritis (TTSH RA) Study Group (2006) The reliability, validity and sensitivity to change of the Chinese version of SF-36 in oriental patients with rheumatoid arthritis. Rheumatology (Oxford) 45(8):1023–1028. https://doi.org/10.1093/rheumatology/kel051CrossRef Koh ET, Leong KP, Tsou IY, Lim VH, Pong LY, Chong SY, Seow A, Tan Tock Seng Hospital Rheumatoid Arthritis (TTSH RA) Study Group (2006) The reliability, validity and sensitivity to change of the Chinese version of SF-36 in oriental patients with rheumatoid arthritis. Rheumatology (Oxford) 45(8):1023–1028. https://​doi.​org/​10.​1093/​rheumatology/​kel051CrossRef
4.
Zurück zum Zitat Staples MP, March L, Lassere M, Reid C, Buchbinder R (2011) Health-related quality of life and continuation rate on first-line anti-tumour necrosis factor therapy among rheumatoid arthritis patients from the Australian Rheumatology Association Database. Rheumatology (Oxford) 50(1):166–175. https://doi.org/10.1093/rheumatology/keq322CrossRef Staples MP, March L, Lassere M, Reid C, Buchbinder R (2011) Health-related quality of life and continuation rate on first-line anti-tumour necrosis factor therapy among rheumatoid arthritis patients from the Australian Rheumatology Association Database. Rheumatology (Oxford) 50(1):166–175. https://​doi.​org/​10.​1093/​rheumatology/​keq322CrossRef
5.
Zurück zum Zitat Heidari B (2011) Rheumatoid arthritis: early diagnosis and treatment outcomes. Caspian J Intern Med 2(1):161–170PubMedPubMedCentral Heidari B (2011) Rheumatoid arthritis: early diagnosis and treatment outcomes. Caspian J Intern Med 2(1):161–170PubMedPubMedCentral
6.
Zurück zum Zitat Khan MA, van der Linden SM (1990) Ankylosing spondylitis and other spondyloarthropathies. Rheum Dis Clin N Am 16:551–579 Khan MA, van der Linden SM (1990) Ankylosing spondylitis and other spondyloarthropathies. Rheum Dis Clin N Am 16:551–579
14.
15.
Zurück zum Zitat Kekow J, Moots RJ, Emery P, Durez P, Koenig A, Singh A, Pedersen R, Robertson D, Freundlich B, Sato R (2010) Patient-reported outcomes improve with etanercept plus methotrexate in active early rheumatoid arthritis and the improvement is strongly associated with remission: the COMET trial. Ann Rheum Dis 69(01):222–225. https://doi.org/10.1136/ard.2008.102509CrossRefPubMed Kekow J, Moots RJ, Emery P, Durez P, Koenig A, Singh A, Pedersen R, Robertson D, Freundlich B, Sato R (2010) Patient-reported outcomes improve with etanercept plus methotrexate in active early rheumatoid arthritis and the improvement is strongly associated with remission: the COMET trial. Ann Rheum Dis 69(01):222–225. https://​doi.​org/​10.​1136/​ard.​2008.​102509CrossRefPubMed
16.
Zurück zum Zitat Gartlehner G, Hansen RA, Jonas BL, Thieda P, Lohr KN (2006) The comparative efficacy and safety of biologics for the treatment of rheumatoid arthritis: a systematic review and metaanalysis. J Rheumatol 33(12):2398–2408PubMed Gartlehner G, Hansen RA, Jonas BL, Thieda P, Lohr KN (2006) The comparative efficacy and safety of biologics for the treatment of rheumatoid arthritis: a systematic review and metaanalysis. J Rheumatol 33(12):2398–2408PubMed
18.
Zurück zum Zitat Tanaka Y, Hirata S, Saleem B, Emery P (2013) Discontinuation of biologics in patients with rheumatoid arthritis. Clin Exp Rheumatol 31(4 Suppl 78):S22–S27PubMed Tanaka Y, Hirata S, Saleem B, Emery P (2013) Discontinuation of biologics in patients with rheumatoid arthritis. Clin Exp Rheumatol 31(4 Suppl 78):S22–S27PubMed
19.
Zurück zum Zitat Smolen JS, Breedveld FC, Burmester GR, Bykerk V, Dougados M, Emery P, Kvien TK, Navarro-Compán MV, Oliver S, Schoels M, Scholte-Voshaar M, Stamm T, Stoffer M, Takeuchi T, Aletaha D, Andreu JL, Aringer M, Bergman M, Betteridge N, Bijlsma H, Burkhardt H, Cardiel M, Combe B, Durez P, Fonseca JE, Gibofsky A, Gomez-Reino JJ, Graninger W, Hannonen P, Haraoui B, Kouloumas M, Landewe R, Martin-Mola E, Nash P, Ostergaard M, Östör A, Richards P, Sokka-Isler T, Thorne C, Tzioufas AG, van Vollenhoven R, de Wit M, van der Heijde D (2016) Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis 75(1):3–15. https://doi.org/10.1136/annrheumdis-2015-207524CrossRefPubMed Smolen JS, Breedveld FC, Burmester GR, Bykerk V, Dougados M, Emery P, Kvien TK, Navarro-Compán MV, Oliver S, Schoels M, Scholte-Voshaar M, Stamm T, Stoffer M, Takeuchi T, Aletaha D, Andreu JL, Aringer M, Bergman M, Betteridge N, Bijlsma H, Burkhardt H, Cardiel M, Combe B, Durez P, Fonseca JE, Gibofsky A, Gomez-Reino JJ, Graninger W, Hannonen P, Haraoui B, Kouloumas M, Landewe R, Martin-Mola E, Nash P, Ostergaard M, Östör A, Richards P, Sokka-Isler T, Thorne C, Tzioufas AG, van Vollenhoven R, de Wit M, van der Heijde D (2016) Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis 75(1):3–15. https://​doi.​org/​10.​1136/​annrheumdis-2015-207524CrossRefPubMed
21.
Zurück zum Zitat Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, Bingham CO III, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, Combe B, Costenbader KH, Dougados M, Emery P, Ferraccioli G, Hazes JMW, Hobbs K, Huizinga TWJ, Kavanaugh A, Kay J, Kvien TK, Laing T, Mease P, Ménard HA, Moreland LW, Naden RL, Pincus T, Smolen JS, Stanislawska-Biernat E, Symmons D, Tak PP, Upchurch KS, Vencovský J, Wolfe F, Hawker G (2010) 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62(9):2569–2581. https://doi.org/10.1002/art.27584CrossRefPubMed Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, Bingham CO III, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, Combe B, Costenbader KH, Dougados M, Emery P, Ferraccioli G, Hazes JMW, Hobbs K, Huizinga TWJ, Kavanaugh A, Kay J, Kvien TK, Laing T, Mease P, Ménard HA, Moreland LW, Naden RL, Pincus T, Smolen JS, Stanislawska-Biernat E, Symmons D, Tak PP, Upchurch KS, Vencovský J, Wolfe F, Hawker G (2010) 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62(9):2569–2581. https://​doi.​org/​10.​1002/​art.​27584CrossRefPubMed
23.
Zurück zum Zitat van Gestel AM, Prevoo ML, van ’t Hof MA, van Rijswijk MH, van de Putte LB, van Riel PL (1996) Development and validation of the European League Against Rheumatism response criteria for rheumatoid arthritis. Comparison with the preliminary American College of Rheumatology and the World Health Organization/International League Against Rheumatism Criteria. Arthritis Rheum 39:34–40CrossRefPubMed van Gestel AM, Prevoo ML, van ’t Hof MA, van Rijswijk MH, van de Putte LB, van Riel PL (1996) Development and validation of the European League Against Rheumatism response criteria for rheumatoid arthritis. Comparison with the preliminary American College of Rheumatology and the World Health Organization/International League Against Rheumatism Criteria. Arthritis Rheum 39:34–40CrossRefPubMed
24.
Zurück zum Zitat Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 21:2286–2291PubMed Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 21:2286–2291PubMed
28.
Zurück zum Zitat Ware JE Jr, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A (1995) Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med Care 33(4 Suppl):AS264–AS279PubMed Ware JE Jr, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A (1995) Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med Care 33(4 Suppl):AS264–AS279PubMed
30.
Zurück zum Zitat Strand V, Singh JA (2008) Improved health-related quality of life with effective disease-modifying antirheumatic drugs: evidence from randomized controlled trials. Am J Manag Care 14(4):234–254PubMed Strand V, Singh JA (2008) Improved health-related quality of life with effective disease-modifying antirheumatic drugs: evidence from randomized controlled trials. Am J Manag Care 14(4):234–254PubMed
33.
Zurück zum Zitat Westhovens R, Cole JC, Li T, Martin M, Maclean R, Lin P et al (2006) Improved health-related quality of life for rheumatoid arthritis patients treated with abatacept who have inadequate response to anti-TNF therapy in a double-blind, placebo-controlled, multicentre randomized clinical trial. Rheumatology (Oxford) 45(10):1238–1246. https://doi.org/10.1093/rheumatology/kel066CrossRef Westhovens R, Cole JC, Li T, Martin M, Maclean R, Lin P et al (2006) Improved health-related quality of life for rheumatoid arthritis patients treated with abatacept who have inadequate response to anti-TNF therapy in a double-blind, placebo-controlled, multicentre randomized clinical trial. Rheumatology (Oxford) 45(10):1238–1246. https://​doi.​org/​10.​1093/​rheumatology/​kel066CrossRef
34.
Zurück zum Zitat Keystone E, Burmester GR, Furie R, Loveless JE, Emery P, Kremer J, Tak PP, Broder MS, Yu E, Cravets M, Magrini F, Jost F (2008) Improvement in patient-reported outcomes in a rituximab trial in patients with severe rheumatoid arthritis refractory to anti-tumor necrosis factor therapy. Arthritis Rheum 59(6):785–793. https://doi.org/10.1002/art.23715CrossRefPubMed Keystone E, Burmester GR, Furie R, Loveless JE, Emery P, Kremer J, Tak PP, Broder MS, Yu E, Cravets M, Magrini F, Jost F (2008) Improvement in patient-reported outcomes in a rituximab trial in patients with severe rheumatoid arthritis refractory to anti-tumor necrosis factor therapy. Arthritis Rheum 59(6):785–793. https://​doi.​org/​10.​1002/​art.​23715CrossRefPubMed
35.
Zurück zum Zitat Strand V, Burmester GR, Ogale S, Devenport J, John A, Emery P (2012) Improvements in health-related quality of life after treatment with tocilizumab in patients with rheumatoid arthritis refractory to tumour necrosis factor inhibitors: results from the 24-week randomized controlled RADIATE study. Rheumatology (Oxford) 51(10):1860–1869. https://doi.org/10.1093/rheumatology/kes131CrossRef Strand V, Burmester GR, Ogale S, Devenport J, John A, Emery P (2012) Improvements in health-related quality of life after treatment with tocilizumab in patients with rheumatoid arthritis refractory to tumour necrosis factor inhibitors: results from the 24-week randomized controlled RADIATE study. Rheumatology (Oxford) 51(10):1860–1869. https://​doi.​org/​10.​1093/​rheumatology/​kes131CrossRef
37.
Zurück zum Zitat van der Heijde DM, Revicki DA, Gooch KL, Wong RL, Kupper H, Harnam N, Thompson C, Sieper J, the ATLAS Study Group (2009) Physical function, disease activity, and health-related quality-of-life outcomes after 3 years of adalimumab treatment in patients with ankylosing spondylitis. Arthritis Res Ther 11(4):R124. https://doi.org/10.1186/ar2790CrossRefPubMedPubMedCentral van der Heijde DM, Revicki DA, Gooch KL, Wong RL, Kupper H, Harnam N, Thompson C, Sieper J, the ATLAS Study Group (2009) Physical function, disease activity, and health-related quality-of-life outcomes after 3 years of adalimumab treatment in patients with ankylosing spondylitis. Arthritis Res Ther 11(4):R124. https://​doi.​org/​10.​1186/​ar2790CrossRefPubMedPubMedCentral
38.
Zurück zum Zitat van der Heijde D, Deodhar A, Braun J, Mack M, Hsu B, Gathany TA, Inman RD, Han C, The GO-RAISE investigators (2014) The effect of golimumab therapy on disease activity and health-related quality of life in patients with ankylosing spondylitis: 2-year results of the GO-RAISE trial. J Rheumatol 41(6):1095–1103. https://doi.org/10.3899/jrheum.131003CrossRefPubMed van der Heijde D, Deodhar A, Braun J, Mack M, Hsu B, Gathany TA, Inman RD, Han C, The GO-RAISE investigators (2014) The effect of golimumab therapy on disease activity and health-related quality of life in patients with ankylosing spondylitis: 2-year results of the GO-RAISE trial. J Rheumatol 41(6):1095–1103. https://​doi.​org/​10.​3899/​jrheum.​131003CrossRefPubMed
39.
Zurück zum Zitat van Herwaarden N, van der Maas A, Minten MJ, van den Hoogen FH, Kievit W, van Vollenhoven RF et al (2015) Disease activity guided dose reduction and withdrawal of adalimumab or etanercept compared with usual care in rheumatoid arthritis: open label, randomised controlled, non-inferiority trial. BMJ 350(apr09 23):h1389. https://doi.org/10.1136/bmj.h1389CrossRefPubMedPubMedCentral van Herwaarden N, van der Maas A, Minten MJ, van den Hoogen FH, Kievit W, van Vollenhoven RF et al (2015) Disease activity guided dose reduction and withdrawal of adalimumab or etanercept compared with usual care in rheumatoid arthritis: open label, randomised controlled, non-inferiority trial. BMJ 350(apr09 23):h1389. https://​doi.​org/​10.​1136/​bmj.​h1389CrossRefPubMedPubMedCentral
44.
Zurück zum Zitat Nishimoto N, Amano K, Hirabayashi Y, Horiuchi T, Ishii T, Iwahashi M, Iwamoto M, Kohsaka H, Kondo M, Matsubara T, Mimura T, Miyahara H, Ohta S, Saeki Y, Saito K, Sano H, Takasugi K, Takeuchi T, Tohma S, Tsuru T, Ueki Y, Yamana J, Hashimoto J, Matsutani T, Murakami M, Takagi N (2014) Drug free REmission/low disease activity after cessation of tocilizumab (Actemra) Monotherapy (DREAM) study. Mod Rheumatol 24(1):17–25. https://doi.org/10.3109/14397595.2013.854079CrossRefPubMed Nishimoto N, Amano K, Hirabayashi Y, Horiuchi T, Ishii T, Iwahashi M, Iwamoto M, Kohsaka H, Kondo M, Matsubara T, Mimura T, Miyahara H, Ohta S, Saeki Y, Saito K, Sano H, Takasugi K, Takeuchi T, Tohma S, Tsuru T, Ueki Y, Yamana J, Hashimoto J, Matsutani T, Murakami M, Takagi N (2014) Drug free REmission/low disease activity after cessation of tocilizumab (Actemra) Monotherapy (DREAM) study. Mod Rheumatol 24(1):17–25. https://​doi.​org/​10.​3109/​14397595.​2013.​854079CrossRefPubMed
45.
Zurück zum Zitat Aguilar-Lozano L, Castillo-Ortiz JD, Vargas-Serafin C, Morales-Torres J, Sanchez-Ortiz A, Sandoval-Castro C, Padilla-Ibarra J, Hernandez-Cuevas C, Ramos-Remus C (2013) Sustained clinical remission and rate of relapse after tocilizumab withdrawal in patients with rheumatoid arthritis. J Rheumatol 40(7):1069–1073. https://doi.org/10.3899/jrheum.121427CrossRefPubMed Aguilar-Lozano L, Castillo-Ortiz JD, Vargas-Serafin C, Morales-Torres J, Sanchez-Ortiz A, Sandoval-Castro C, Padilla-Ibarra J, Hernandez-Cuevas C, Ramos-Remus C (2013) Sustained clinical remission and rate of relapse after tocilizumab withdrawal in patients with rheumatoid arthritis. J Rheumatol 40(7):1069–1073. https://​doi.​org/​10.​3899/​jrheum.​121427CrossRefPubMed
46.
Zurück zum Zitat Kavanaugh A, Lee SJ, Curtis JR, Greenberg JD, Kremer JM, Soto L, Etzel CJ, Cox V, Yoshida K, Reed GW, Solomon DH (2015) Discontinuation of tumour necrosis factor inhibitors in patients with rheumatoid arthritis in low-disease activity: persistent benefits. Data from the Corrona registry. Ann Rheum Dis 74(6):1150–1155. https://doi.org/10.1136/annrheumdis-2014-206435CrossRefPubMed Kavanaugh A, Lee SJ, Curtis JR, Greenberg JD, Kremer JM, Soto L, Etzel CJ, Cox V, Yoshida K, Reed GW, Solomon DH (2015) Discontinuation of tumour necrosis factor inhibitors in patients with rheumatoid arthritis in low-disease activity: persistent benefits. Data from the Corrona registry. Ann Rheum Dis 74(6):1150–1155. https://​doi.​org/​10.​1136/​annrheumdis-2014-206435CrossRefPubMed
Metadaten
Titel
Health-related quality of life outcomes in patients with rheumatoid arthritis and ankylosing spondylitis after tapering biologic treatment
verfasst von
Ming-Han Chen
Mei-Hsuan Lee
Hsien-Tzung Liao
Wei-Sheng Chen
Chien-Chih Lai
Chang-Youh Tsai
Publikationsdatum
06.01.2018
Verlag
Springer London
Erschienen in
Clinical Rheumatology / Ausgabe 2/2018
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-017-3965-2

Weitere Artikel der Ausgabe 2/2018

Clinical Rheumatology 2/2018 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.