The effect of intravenous golimumab on health-related quality of life in rheumatoid arthritis: 24-week results of the phase III GO-FURTHER trial.
OBJECTIVE
To evaluate the effects of intravenous (IV) golimumab 2 mg/kg + methotrexate (MTX) on patient-reported measures of health-related quality of life (HRQOL) in patients with active rheumatoid arthritis (RA) despite prior MTX therapy.


METHODS
In this randomized, multicenter, double-blind, placebo-controlled, phase III trial, adults with RA were randomly assigned to receive IV placebo (n = 197) or golimumab 2 mg/kg (n = 395) infusions at Week 0, Week 4, and every 8 weeks thereafter. All patients continued stable oral MTX (15-25 mg/wk). HRQOL assessments included Health Assessment Questionnaire-Disability Index (HAQ-DI; physical function), Medical Outcomes Study Short Form-36 questionnaire physical/mental component summary (SF-36 PCS/MCS) scores, EQ-5D assessment of current health state, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) questionnaire, and disease effect on productivity [10-cm visual analog scale (VAS)].


RESULTS
Mean HAQ-DI improvements from baseline were significantly greater with golimumab + MTX than placebo + MTX at Week 14 and Week 24 (p < 0.001). Significantly greater improvements in all 8 individual SF-36 subscores and both the SF-36 PCS and MCS scores (p < 0.001) also accompanied golimumab + MTX therapy. Improved EQ-5D and EQ-5D VAS (p < 0.001) and FACIT-Fatigue (p < 0.001) scores were also observed for golimumab + MTX-treated patients at Week 12, Week 16, and Week 24, and greater proportions of golimumab + MTX-treated patients had clinically meaningful improvements in these measures. Greater reductions in disease effect on productivity were observed with golimumab + MTX versus placebo + MTX at Week 24 (p < 0.001). Improvements in physical function, HRQOL, fatigue, and productivity significantly correlated with disease activity improvement.


CONCLUSIONS
In active RA, IV golimumab + MTX significantly improved physical function, HRQOL, fatigue, and productivity using multiple measurement tools; all correlated with improvements in disease activity (NCT00973479, EudraCT 2008-006064-11).
From the Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, Maryland; Department of Clinical Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts; Patient Reported Outcomes, Janssen Global Services LLC, Malvern, Pennsylvania; Biostatistics and Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA; Department of Rheumatology, UZ Gasthuisberg, KU Leuven, Belgium.C.O. Bingham III, MD, Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University; M. Weinblatt, MD, Department of Clinical Rheumatology, Brigham and Women's Hospital; C. Han, PhD; T.A. Gathany, PhD, Patient Reported Outcomes, Janssen Global Services; L. Kim, PhD; K.H. Lo, PhD, Biostatistics, Janssen Research & Development LLC; D. Baker, MD; A. Mendelsohn, MD, Immunology, Janssen Research & Development LLC; R. Westhovens, MD, Department of Rheumatology, University Hospitals Leuven; Department of Development and Regeneration, KU Leuven. cbingha2@jhmi.edu.
Clifton O
CO
Bingham
From the Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, Maryland; Department of Clinical Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts; Patient Reported Outcomes, Janssen Global Services LLC, Malvern, Pennsylvania; Biostatistics and Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA; Department of Rheumatology, UZ Gasthuisberg, KU Leuven, Belgium.C.O. Bingham III, MD, Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University; M. Weinblatt, MD, Department of Clinical Rheumatology, Brigham and Women's Hospital; C. Han, PhD; T.A. Gathany, PhD, Patient Reported Outcomes, Janssen Global Services; L. Kim, PhD; K.H. Lo, PhD, Biostatistics, Janssen Research & Development LLC; D. Baker, MD; A. Mendelsohn, MD, Immunology, Janssen Research & Development LLC; R. Westhovens, MD, Department of Rheumatology, University Hospitals Leuven; Department of Development and Regeneration, KU Leuven.
Michael
M
Weinblatt
From the Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, Maryland; Department of Clinical Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts; Patient Reported Outcomes, Janssen Global Services LLC, Malvern, Pennsylvania; Biostatistics and Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA; Department of Rheumatology, UZ Gasthuisberg, KU Leuven, Belgium.C.O. Bingham III, MD, Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University; M. Weinblatt, MD, Department of Clinical Rheumatology, Brigham and Women's Hospital; C. Han, PhD; T.A. Gathany, PhD, Patient Reported Outcomes, Janssen Global Services; L. Kim, PhD; K.H. Lo, PhD, Biostatistics, Janssen Research & Development LLC; D. Baker, MD; A. Mendelsohn, MD, Immunology, Janssen Research & Development LLC; R. Westhovens, MD, Department of Rheumatology, University Hospitals Leuven; Department of Development and Regeneration, KU Leuven.
Chenglong
C
Han
From the Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, Maryland; Department of Clinical Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts; Patient Reported Outcomes, Janssen Global Services LLC, Malvern, Pennsylvania; Biostatistics and Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA; Department of Rheumatology, UZ Gasthuisberg, KU Leuven, Belgium.C.O. Bingham III, MD, Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University; M. Weinblatt, MD, Department of Clinical Rheumatology, Brigham and Women's Hospital; C. Han, PhD; T.A. Gathany, PhD, Patient Reported Outcomes, Janssen Global Services; L. Kim, PhD; K.H. Lo, PhD, Biostatistics, Janssen Research & Development LLC; D. Baker, MD; A. Mendelsohn, MD, Immunology, Janssen Research & Development LLC; R. Westhovens, MD, Department of Rheumatology, University Hospitals Leuven; Department of Development and Regeneration, KU Leuven.
Timothy A
TA
Gathany
From the Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, Maryland; Department of Clinical Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts; Patient Reported Outcomes, Janssen Global Services LLC, Malvern, Pennsylvania; Biostatistics and Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA; Department of Rheumatology, UZ Gasthuisberg, KU Leuven, Belgium.C.O. Bingham III, MD, Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University; M. Weinblatt, MD, Department of Clinical Rheumatology, Brigham and Women's Hospital; C. Han, PhD; T.A. Gathany, PhD, Patient Reported Outcomes, Janssen Global Services; L. Kim, PhD; K.H. Lo, PhD, Biostatistics, Janssen Research & Development LLC; D. Baker, MD; A. Mendelsohn, MD, Immunology, Janssen Research & Development LLC; R. Westhovens, MD, Department of Rheumatology, University Hospitals Leuven; Department of Development and Regeneration, KU Leuven.
Lilianne
L
Kim
From the Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, Maryland; Department of Clinical Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts; Patient Reported Outcomes, Janssen Global Services LLC, Malvern, Pennsylvania; Biostatistics and Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA; Department of Rheumatology, UZ Gasthuisberg, KU Leuven, Belgium.C.O. Bingham III, MD, Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University; M. Weinblatt, MD, Department of Clinical Rheumatology, Brigham and Women's Hospital; C. Han, PhD; T.A. Gathany, PhD, Patient Reported Outcomes, Janssen Global Services; L. Kim, PhD; K.H. Lo, PhD, Biostatistics, Janssen Research & Development LLC; D. Baker, MD; A. Mendelsohn, MD, Immunology, Janssen Research & Development LLC; R. Westhovens, MD, Department of Rheumatology, University Hospitals Leuven; Department of Development and Regeneration, KU Leuven.
Kim Hung
KH
Lo
From the Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, Maryland; Department of Clinical Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts; Patient Reported Outcomes, Janssen Global Services LLC, Malvern, Pennsylvania; Biostatistics and Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA; Department of Rheumatology, UZ Gasthuisberg, KU Leuven, Belgium.C.O. Bingham III, MD, Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University; M. Weinblatt, MD, Department of Clinical Rheumatology, Brigham and Women's Hospital; C. Han, PhD; T.A. Gathany, PhD, Patient Reported Outcomes, Janssen Global Services; L. Kim, PhD; K.H. Lo, PhD, Biostatistics, Janssen Research & Development LLC; D. Baker, MD; A. Mendelsohn, MD, Immunology, Janssen Research & Development LLC; R. Westhovens, MD, Department of Rheumatology, University Hospitals Leuven; Department of Development and Regeneration, KU Leuven.
Dan
D
Baker
From the Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, Maryland; Department of Clinical Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts; Patient Reported Outcomes, Janssen Global Services LLC, Malvern, Pennsylvania; Biostatistics and Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA; Department of Rheumatology, UZ Gasthuisberg, KU Leuven, Belgium.C.O. Bingham III, MD, Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University; M. Weinblatt, MD, Department of Clinical Rheumatology, Brigham and Women's Hospital; C. Han, PhD; T.A. Gathany, PhD, Patient Reported Outcomes, Janssen Global Services; L. Kim, PhD; K.H. Lo, PhD, Biostatistics, Janssen Research & Development LLC; D. Baker, MD; A. Mendelsohn, MD, Immunology, Janssen Research & Development LLC; R. Westhovens, MD, Department of Rheumatology, University Hospitals Leuven; Department of Development and Regeneration, KU Leuven.
Alan
A
Mendelsohn
From the Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, Maryland; Department of Clinical Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts; Patient Reported Outcomes, Janssen Global Services LLC, Malvern, Pennsylvania; Biostatistics and Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA; Department of Rheumatology, UZ Gasthuisberg, KU Leuven, Belgium.C.O. Bingham III, MD, Division of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University; M. Weinblatt, MD, Department of Clinical Rheumatology, Brigham and Women's Hospital; C. Han, PhD; T.A. Gathany, PhD, Patient Reported Outcomes, Janssen Global Services; L. Kim, PhD; K.H. Lo, PhD, Biostatistics, Janssen Research & Development LLC; D. Baker, MD; A. Mendelsohn, MD, Immunology, Janssen Research & Development LLC; R. Westhovens, MD, Department of Rheumatology, University Hospitals Leuven; Department of Development and Regeneration, KU Leuven.
Rene
R
Westhovens
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000523:psychology; D004185:Disability Evaluation; D004311:Double-Blind Method; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; C529000:golimumab
ANTI-TUMOR NECROSIS FACTOR; FATIGUE; PHYSICAL FUNCTION; QUALITY OF LIFE; RHEUMATOID ARTHRITIS