Improvements in quality of life and functional status in patients with psoriatic arthritis receiving anti-tumor necrosis factor therapies.
OBJECTIVE
To evaluate the impact of anti-tumor necrosis factor (anti-TNF) therapies on quality of life (QOL) and functional status in psoriatic arthritis (PsA) patients and study potential predictors for QOL improvements.


METHODS
The study was based on a cohort of 596 PsA patients receiving anti-TNF therapies. Changes in functional status and QOL were assessed using the Health Assessment Questionnaire (HAQ) and Short Form 36 (SF-36) questionnaire on a 6-month basis. The Short Form 6D (SF-6D) was calculated as a utility score. Univariate and multivariate linear regression models were developed to examine potential predictors of QOL improvements at 6 months, using a range of demographic, baseline disease-specific, and therapeutic variables.


RESULTS
At 6 months, significant improvements in all SF-36 subscale scores were found, with the greatest percentage improvement from baseline related to physical role (113.8%; 95% confidence interval [95% CI] 102.6, 125.0). The percent improvement for the physical component scale was 53.2% (95% CI 44.5, 61.9) at 6 months, whereas that for the mental component scale was 16.9% (95% CI 14.7, 19.2). The mean +/- SD SF-6D score was 0.58 +/- 0.07 at baseline, and this improved to 0.63 +/- 0.06 at 6 months. The median HAQ score at baseline was 1.88 (interquartile range [IQR] 1.38-2.25) for the entire cohort, and this improved to 1.25 (IQR 0.63-1.88) at 6 months. Improvements in Disease Activity Score in 28 joints at 6 months were found to be significantly associated with QOL improvements at the same time point.


CONCLUSIONS
Anti-TNF therapy is associated with improvement in both physical and mental status in PsA patients. These improvements were most substantial in patients who also had improvements in their disease activity.
Saad
Amr A
AA
School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK.
Ashcroft
Darren M
DM
Watson
Kath D
KD
Symmons
Deborah P M
DP
Noyce
Peter R
PR
Hyrich
Kimme L
KL
D000068879:Adalimumab; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D001685:Biological Factors / Q000627:therapeutic use*; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D000069285:Infliximab; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D020127:Recovery of Function; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001685:Biological Factors; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept
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