Biological Therapy in Patients with Rheumatoid Arthritis in a Tertiary Center in Portugal: A Cross-Sectional Study
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , , , , |
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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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 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
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article |
status_str |
publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605 oai:ojs.www.actamedicaportuguesa.com:article/13605 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605 |
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eng |
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eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605 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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Direitos de Autor (c) 2021 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2021 Acta Médica Portuguesa |
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Ordem dos Médicos |
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Ordem dos Médicos |
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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 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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