title: Health-related quality of life in patients with long-standing rheumatoid arthritis in the era of biologics: data from the German biologics register RABBIT.
abstract: OBJECTIVE
  To compare the 24-month course of health-related quality of life (HRQoL) in patients with long-standing RA treated with a conventional synthetic (cs) or a first, second or third biologic (b) DMARD in daily rheumatological care.
  
  
  METHODS
  Patients enrolled in the German biologics register RABBIT who were observed over at least 12 months were stratified according to the nth bDMARD started at enrolment. HRQoL was captured by the SF36 health survey. Within strata of sequential bDMARD therapy, we examined patients' HRQoL at baseline and at follow-ups in comparison with the general population, the 24-month course of HRQoL of different bDMARDs and the proportion of patients exceeding the minimal detectable improvement of physical and mental health sum scores.
  
  
  RESULTS
  All patients reported remarkably lower scores of physical and mental health than the general population at baseline and month 12. In each stratum of sequential bDMARD therapy, patients improved significantly by month 12 and remained stable until month 24. The improvement of HRQoL was not attributable to a particular bDMARD. The following proportions of patients exceeded the minimal detectable improvement of at least 17.85 Physical Component Scale scores or 22.18 Mental Component Scale score points: csDMARD (n = 1113) 31.1%/22.3%, first bDMARD (n = 1352) 39.9%/29.7%, second bDMARD (n = 730) 37.3%/26.2% and third bDMARD (n = 680) 34.2%/30.9%.
  
  
  CONCLUSIONS
  Lasting improvement of both physical and mental health is achievable even for severely affected RA patients with a history of more than one bDMARD failure. Nevertheless, impairment of HRQoL in RA patients is enormous compared with the general population.
authors.affiliation: Programmbereich Epidemiologie, Deutsches Rheuma-Forschungszentrum Berlin, Ein Leibniz Institut, Berlin, Kinder- und Jugendrheumatologie, Sozialpädiatrisches Zentrum, Charité - Universitätsmedizin Berlin.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Gerhold
authors.affiliation: Programmbereich Epidemiologie, Deutsches Rheuma-Forschungszentrum Berlin, Ein Leibniz Institut, Berlin, richter@drfz.de.
authors.forename: Adrian
authors.initials: A
authors.lastname: Richter
authors.affiliation: Heinrich-Heine-Universität Düsseldorf.
authors.forename: Matthias
authors.initials: M
authors.lastname: Schneider
authors.affiliation: Wedau-Klinikum, Duisburg.
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Bergerhausen
authors.affiliation: Private Practice, Hildesheim.
authors.forename: Winfried
authors.initials: W
authors.lastname: Demary
authors.affiliation: Private Practice, Halle and.
authors.forename: Anke
authors.initials: A
authors.lastname: Liebhaber
authors.affiliation: Programmbereich Epidemiologie, Deutsches Rheuma-Forschungszentrum Berlin, Ein Leibniz Institut, Berlin.
authors.forename: Joachim
authors.initials: J
authors.lastname: Listing
authors.affiliation: Programmbereich Epidemiologie, Deutsches Rheuma-Forschungszentrum Berlin, Ein Leibniz Institut, Berlin, Klinik für Rheumatologie und Klinische Immunologie, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Zink
authors.affiliation: Programmbereich Epidemiologie, Deutsches Rheuma-Forschungszentrum Berlin, Ein Leibniz Institut, Berlin.
authors.forename: Anja
authors.initials: A
authors.lastname: Strangfeld
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D001688:Biological Products / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012042:Registries; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products
keywords: biologics register; health-related quality of life; minimal detectable change; rheumatoid arthritis