Patient-reported outcomes following biologic therapy in a sample of adults with rheumatoid arthritis recruited from community-based rheumatologists.
OBJECTIVE
To examine self-reported symptoms and functioning in a community-based sample of persons with rheumatoid arthritis who did and did not initiate treatment with biologic agents.


METHODS
Data were from annual telephone interviews (1998-2003) with an observational cohort identified through community rheumatologists. Self-reported function and symptoms of subjects who initiated biologic therapy (etanercept or infliximab) and reported consistent use at 2 annual interviews (continuous use; n = 64) were compared at 1 year prior to initiation of therapy (baseline), and years 1 and 2 of therapy to those with no biologic therapy (n = 183) and those who initiated biologic therapy but discontinued use (n = 42).


RESULTS
At baseline, subjects taking biologic agents reported significantly worse function and symptoms on all measures except fatigue and pain severity. After 2 years, significant differences in the Health Assessment Questionnaire scores remained, but there were no other significant differences between the nonuser group and the continuous use group. The discontinued use group exhibited significantly greater pain severity and more painful joints than nonusers. Improvements in the number of painful (33.4% versus 16.2%; P = 0.004), and swollen (38.4% versus 18.7%; P = 0.003) joints, and morning stiffness (27.3% versus 10.4%; P = 0.001) were more frequent in the continuous use group than in the nonuser group.


CONCLUSIONS
Results suggest that biologic treatment was initiated based on severe disease. Over approximately 17 months of treatment, differences in some but not all symptoms between the continuous use group and the nonuser group narrowed to statistical nonsignificance.
Katz
Patricia
P
University of California, San Francisco, CA 94143, USA. patti.katz@ucsf.edu
Yelin
Edward
E
Patel
Vaishali
V
Huang
Xing-Yue
XY
Chiou
Chiun-Fang
CF
D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D015331:Cohort Studies; D055812:Community-Based Participatory Research; D000068800:Etanercept; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D000069285:Infliximab; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000069285:Infliximab; D000068800:Etanercept