Patient and physician expectations of add-on treatment with golimumab for rheumatoid arthritis: relationships between expectations and clinical and quality of life outcomes.
OBJECTIVE
Rheumatoid arthritis (RA) management involves improving clinical outcomes and quality of life (QOL). Golimumab is used as add-on therapy for patients who have failed disease-modifying antirheumatic drugs (DMARDs). This GO-MORE subanalysis investigated relationships between patient and physician expectations and outcomes.


METHODS
GO-MORE was an open-label, multinational, prospective study in biologic agent-naive patients with active RA despite DMARD treatment. Patients received 50 mg subcutaneous golimumab monthly for 6 months. At baseline and month 3, patients rated treatment expectations for the following 3 months using 5-point scales (where 1 = good and 5 = poor). Outcomes were compared among expectation tertiles: most positive, intermediate, and least positive. At baseline and month 3, physicians predicted patient disease state 3 months later.


RESULTS
At baseline, 3,280 efficacy-evaluable patients with moderate (21.3%) or high (78.7%) disease activity had mean ± SD disease duration of 7.6 ± 7.9 years, mean ± SD Health Assessment Questionnaire (HAQ) disability index (DI) score of 1.44 ± 0.67, and mean ± SD EuroQol 5-domain (EQ-5D) score of 0.42 ± 0.33. Patients reported high treatment expectations (mean 1.43); 95.9% expected golimumab to be better than current treatment. Patients with fewer DMARD failures, higher disease activity, shorter disease duration, younger age, and female sex reported higher expectations (P < 0.05 for all). After 6 months, patients with the most positive expectations had higher remission rates (P < 0.0001) and greater HAQ DI (P < 0.0001) and EQ-5D (P < 0.0001) score improvements. At baseline, physicians expected 29.6% and 59.2% of patients to attain remission and low disease activity, respectively, after 3 months.


CONCLUSIONS
Patients had high expectations for golimumab treatment. Patients with more positive expectations had greater remission rates, improvements in function, and QOL.
Southend University Hospital, Westcliff-on-Sea, UK.
Bhaskar
B
Dasgupta
Bernard
B
Combe
Ingrid
I
Louw
Jürgen
J
Wollenhaupt
Cristiano A F
CA
Zerbini
Andre
A
Beaulieu
Hendrik
H
Schulze-Koops
Patrick
P
Durez
Verónica
V
Wolff
Ruji
R
Yao
Haoling H
HH
Weng
Marinella
M
Govoni
Nathan
N
Vastesaeger
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012074:Remission Induction; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; C529000:golimumab