Improved health-related quality of life with effective disease-modifying
antirheumatic drugs: evidence from randomized controlled trials.
Author(s): Strand V, Singh JA.
Affiliation(s): Division of Immunology/Rheumatology, Stanford University School of Medicine, 306
Ramona Rd, Portola Valley, CA 94028, USA. vstrand@aol.com
Publication date & source: 2007, Am J Manag Care. , 13 Suppl 9:S237-51
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by
inflammation of the articular synovium, resulting in bony erosions, deformity,
and, ultimately, joint destruction. With associated comorbid conditions,
especially cardiovascular, it can result in significant morbidity as well as
early mortality. Patients with RA report impairments in health-related quality of
life (HRQOL) in comparison with age- and sex-matched populations without
arthritis. These decreases in HRQOL are attributed to the pain, impairment in
physical function, and fatigue associated with this disease. The introduction of
new disease-modifying antirheumatic drugs has revolutionized the treatment of RA,
particularly the biologic agents: etanercept, infliximab, adalimumab, abatacept,
and rituximab. Importantly, administration of these agents has resulted in
statistically significant and clinically meaningful improvements in physical
function and HRQOL. Many clinical studies confirm that with these therapies, RA
patients report improvements in HRQOL, reflected by improved physical function,
less fatigue, and better emotional and mental function. Maintenance of physical
function is no longer the only treatment goal for RA but also to improve,
restore, and preserve HRQOL. Results from pivotal clinical trials are analyzed in
this article and the relevance of the data derived from the clinical studies to
day-to-day clinical practice are also discussed.
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