Dataset Information

Remission in rheumatoid arthritis: benefit over low disease activity in patient-reported outcomes and costs.

ABSTRACT:

Introduction

Rheumatoid arthritis (RA) is a chronic inflammatory disease that causes a considerable burden for the patient and society. It is not clear yet whether aiming for remission (REM) is worthwhile, especially when compared with low disease activity (LDA).

Methods

In 356 consecutive RA patients, we obtained data on physical function (health assessment questionnaire (HAQ)), health-related quality of life (HRQoL: Short Form 36 (SF36), Short Form 6 dimensions (SF-6D), Euro QoL 5D (EQ-5D)), work productivity (work productivity and activity impairment questionnaire (WPAI)), as well as estimation of direct and indirect costs. Cross-sectionally, data were compared in patients within different levels of disease activity according to the simplified disease activity index (SDAI; remission (REM ?3.3); n?=?87; low disease activity (LDA: 3.3?11 n?=?119) by using analyses of variance (ANOVA). Longitudinal investigations assessed patients who changed from LDA to REM and vice versa.

Results

We found differences in patients achieving REM compared with LDA for HAQ (0.39?±?0.58 versus 0.72?±?68), WPAI (percentage impairment while working 11.8%?±?18.7% versus 26.8%?±?23.9%; percentage of overall activity impairment, 10.8%?±?14.1% versus 29.0%?±?23.6%)), EQ-5D (0.89?±?0.12 versus 0.78?±?0.6) and SF-36 (physical component score (PCS): 46.0?±?8.6 versus 38.3?±?10.5; mental component score (MCS): 49.9?±?11.1 versus 47.9?±?12.3) (P?ConclusionPatients with REM show better function, HRQoL, and productivity, even when compared with another good state, such as LDA. Also from a cost perspective, REM appears superior to all other states.

SUBMITTER: Radner H

PROVIDER: S-EPMC3979137 | biostudies-literature | 2014 Feb

REPOSITORIES: biostudies-literature

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Publications

Remission in rheumatoid arthritis: benefit over low disease activity in patient-reported outcomes and costs.

Radner Helga H Smolen Josef S JS Aletaha Daniel D

Arthritis research & therapy 20140221 1

<h4>Introduction</h4>Rheumatoid arthritis (RA) is a chronic inflammatory disease that causes a considerable burden for the patient and society. It is not clear yet whether aiming for remission (REM) is worthwhile, especially when compared with low disease activity (LDA).<h4>Methods</h4>In 356 consecutive RA patients, we obtained data on physical function (health assessment questionnaire (HAQ)), health-related quality of life (HRQoL: Short Form 36 (SF36), Short Form 6 dimensions (SF-6D), Euro QoL ...[more]

PMID: 24555808

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Project description:ObjectiveTo evaluate the effect of upadacitinib (UPA) monotherapy vs MTX on patient-reported outcomes (PROs) in patients with RA who were MTX-naïve or who had an inadequate response to MTX (MTX-IR).MethodsPROs from the SELECT-EARLY and SELECT-MONOTHERAPY randomized controlled trials were evaluated at Weeks 2 and 12/14. Patients were ≥18 years of age with RA symptoms for ≥6 weeks (SELECT-EARLY, MTX-naïve) or diagnosed RA for ≥3 months (SELECT-MONOTHERAPY, MTX-IR) and received UPA monotherapy (15 or 30 mg) or MTX. PROs included Patient Global Assessment of Disease Activity (PtGA), pain visual analogue scale, HAQ Disability Index (HAQ-DI), morning stiffness duration/severity, Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue (SELECT-EARLY), health-related quality of life (HRQOL) by the 36-iem Short Form Health Survey and Work Productivity and Activity Impairment (WPAI; SELECT-EARLY). Least square mean (LSM) changes and proportions of patients reporting improvements greater than or equal to the minimum clinically important differences and normative values were determined.ResultsIn 945 MTX-naïve and 648 MTX-IR patients, UPA monotherapy (15 mg, 30 mg) vs MTX resulted in greater reported LSM changes from baseline at Weeks 12/14 in PtGA, pain, HAQ-DI, morning stiffness duration/severity, FACIT-F (SELECT-EARLY), HRQOL and WPAI (SELECT-EARLY). These changes were statistically significant with both doses of UPA vs MTX at Weeks 12/14 in both RCTs. Improvements were reported as early as week 2. Compared with MTX, more UPA-treated MTX-naïve and MTX-IR patients reported improvements greater than or equal to the minimum clinically important differences and scores greater than or equal to normative values.ConclusionAmong MTX-naïve and MTX-IR patients with active RA, UPA monotherapy at 15 or 30 mg for 12/14 weeks resulted in statistically significant and clinically meaningful improvements in pain, physical function, morning stiffness, HRQOL and WPAI compared with MTX alone.Clinical trial registration numberSELECT-EARLY (NCT02706873) and SELECT-MONOTHERAPY (NCT02706951) are registered with ClinicalTrials.gov.

Dataset Information

Remission in rheumatoid arthritis: benefit over low disease activity in patient-reported outcomes and costs.

Introduction

Methods

Results

Publications

Remission in rheumatoid arthritis: benefit over low disease activity in patient-reported outcomes and costs.

Similar Datasets

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