Biological Therapy in Patients with Rheumatoid Arthritis in a Tertiary Center in Portugal: A Cross-Sectional Study

Detalhes bibliográficos
Autor(a) principal: Fernandes, Melissa
Data de Publicação: 2021
Outros Autores: Figueiredo, Adelaide, Oliveira, Ana Luísa, Ferreira, Ana Carolina, Mendonça, Pedro, Taulaigo, Anna V., Vicente, Madalena, Fanica, Maria João, Ruano, Carina, Panarra, António, Mateus, Céu, Moraes-Fontes, Maria Francisca
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605
Resumo: Introduction: Clinical 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 Methods: Cross-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.Results: Recall 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.Discussion: A high disease activity and a high HAQ disability index characterized most patients at pre-bDMARD onset.Conclusion: Despite 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.
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spelling Biological Therapy in Patients with Rheumatoid Arthritis in a Tertiary Center in Portugal: A Cross-Sectional StudyArtrite Reumatóide em Doentes Submetidos a Terapêutica Biológica num Centro Terciário de Referenciação em Portugal: Um Estudo TransversalArthritisRheumatoid/drug therapyBiological Products/therapeutic useBiological TherapyQuality of LifeArtrite Reumatoide/tratamento farmacológicoBiológicos/uso terapêuticoQualidade de VidaTerapia BiológicaIntroduction: Clinical 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 Methods: Cross-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.Results: Recall 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.Discussion: A high disease activity and a high HAQ disability index characterized most patients at pre-bDMARD onset.Conclusion: Despite 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.Introdução: Avanços no tratamento da artrite reumatóide contribuiram para uma evolução favorável. Apesar de evidências substanciais provenientes de ensaios clínicos, são menos conhecidos os dados provenientes da vida real. O objetivo do estudo foi caracterizar a doença e a qualidade de vida em doentes sob fármacos biotecnológicos.Material e Métodos: Trata-se de um estudo transversal com recolha de dados clínicos relativos à adesão terapêutica, atividade da doença, capacidade funcional, deformidades articulares, comorbilidades e questionários de qualidade de vida relacionada com a saúde, estado civil, situação profissional e escolaridade.Resultados: Foram recrutados 77 doentes do grupo original de um total de 94. A mediana da idade foi 63 anos, 82% do sexo feminino e início de biológico cerca de quatro anos após o início da doença, com uma mediana de duração de 12 anos. De acordo com o disease activity score (DAS28), a percentagem de doentes com atividade alta, moderada, baixa ou em remissão mudou, respectivamente, de 50, 45, 0 e 5 pré- biológico para 11, 37, 25 e 26 na altura da re-avaliação, com melhoria funcional. Setenta e cinco por cento dos doentes mantiveram o tratamento original com boa adesão. Pontuações mais baixas do short form-36 associaram-se a uma baixa pontuação no EQ-5D-3L. No grupo de doentes que viriam a falecer (n = 6), foi observada uma menor esperança de vida aos 10 anos, assim como uma maior discontinuação da terapêutica biológica.Discussão: Pré-biológico, uma elevada percentagem dos doentes apresentava elevada atividade da doença e incapacidade funcional.Conclusão: Não obstante ajustes terapêuticos e seguimento regular, uma percentagem significativa de doentes mantinha atividade moderada e limitação funcional com baixa qualidade de vida relacionada com a saúde.Ordem dos Médicos2021-05-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentimage/tiffapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605oai:ojs.www.actamedicaportuguesa.com:article/13605Acta Médica Portuguesa; Vol. 34 No. 5 (2021): May; 362-371Acta Médica Portuguesa; Vol. 34 N.º 5 (2021): Maio; 362-3711646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/6261https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/6262https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12323https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12325https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12326https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12327https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12328https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12329https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12465https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12582https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12583https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12584https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12715https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12716https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12717https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12718https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12845https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/13201https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/13202Direitos de Autor (c) 2021 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessFernandes, MelissaFigueiredo, AdelaideOliveira, Ana LuísaFerreira, Ana CarolinaMendonça, PedroTaulaigo, Anna V.Vicente, MadalenaFanica, Maria JoãoRuano, CarinaPanarra, AntónioMateus, CéuMoraes-Fontes, Maria Francisca2022-12-20T11:06:56Zoai:ojs.www.actamedicaportuguesa.com:article/13605Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:22.622692Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Biological Therapy in Patients with Rheumatoid Arthritis in a Tertiary Center in Portugal: A Cross-Sectional Study
Artrite Reumatóide em Doentes Submetidos a Terapêutica Biológica num Centro Terciário de Referenciação em Portugal: Um Estudo Transversal
title Biological Therapy in Patients with Rheumatoid Arthritis in a Tertiary Center in Portugal: A Cross-Sectional Study
spellingShingle Biological Therapy in Patients with Rheumatoid Arthritis in a Tertiary Center in Portugal: A Cross-Sectional Study
Fernandes, Melissa
Arthritis
Rheumatoid/drug therapy
Biological Products/therapeutic use
Biological Therapy
Quality of Life
Artrite Reumatoide/tratamento farmacológico
Biológicos/uso terapêutico
Qualidade de Vida
Terapia Biológica
title_short Biological Therapy in Patients with Rheumatoid Arthritis in a Tertiary Center in Portugal: A Cross-Sectional Study
title_full Biological Therapy in Patients with Rheumatoid Arthritis in a Tertiary Center in Portugal: A Cross-Sectional Study
title_fullStr Biological Therapy in Patients with Rheumatoid Arthritis in a Tertiary Center in Portugal: A Cross-Sectional Study
title_full_unstemmed Biological Therapy in Patients with Rheumatoid Arthritis in a Tertiary Center in Portugal: A Cross-Sectional Study
title_sort Biological Therapy in Patients with Rheumatoid Arthritis in a Tertiary Center in Portugal: A Cross-Sectional Study
author Fernandes, Melissa
author_facet Fernandes, Melissa
Figueiredo, Adelaide
Oliveira, Ana Luísa
Ferreira, Ana Carolina
Mendonça, Pedro
Taulaigo, Anna V.
Vicente, Madalena
Fanica, Maria João
Ruano, Carina
Panarra, António
Mateus, Céu
Moraes-Fontes, Maria Francisca
author_role author
author2 Figueiredo, Adelaide
Oliveira, Ana Luísa
Ferreira, Ana Carolina
Mendonça, Pedro
Taulaigo, Anna V.
Vicente, Madalena
Fanica, Maria João
Ruano, Carina
Panarra, António
Mateus, Céu
Moraes-Fontes, Maria Francisca
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Fernandes, Melissa
Figueiredo, Adelaide
Oliveira, Ana Luísa
Ferreira, Ana Carolina
Mendonça, Pedro
Taulaigo, Anna V.
Vicente, Madalena
Fanica, Maria João
Ruano, Carina
Panarra, António
Mateus, Céu
Moraes-Fontes, Maria Francisca
dc.subject.por.fl_str_mv Arthritis
Rheumatoid/drug therapy
Biological Products/therapeutic use
Biological Therapy
Quality of Life
Artrite Reumatoide/tratamento farmacológico
Biológicos/uso terapêutico
Qualidade de Vida
Terapia Biológica
topic Arthritis
Rheumatoid/drug therapy
Biological Products/therapeutic use
Biological Therapy
Quality of Life
Artrite Reumatoide/tratamento farmacológico
Biológicos/uso terapêutico
Qualidade de Vida
Terapia Biológica
description Introduction: Clinical 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 Methods: Cross-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.Results: Recall 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.Discussion: A high disease activity and a high HAQ disability index characterized most patients at pre-bDMARD onset.Conclusion: Despite 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.
publishDate 2021
dc.date.none.fl_str_mv 2021-05-02
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/6261
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/6262
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12323
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12325
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12326
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12327
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12328
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12329
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12465
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12582
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12583
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12584
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12715
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12716
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12717
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12718
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/12845
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/13201
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605/13202
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 34 No. 5 (2021): May; 362-371
Acta Médica Portuguesa; Vol. 34 N.º 5 (2021): Maio; 362-371
1646-0758
0870-399X
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