Background/Purpose:

Major advances in the management of rheumatoid arthritis (RA) have been recorded over the last decade thanks to the introduction of biologics. However, medical needs concerning functioning and quality of life of patients are not completely fulfilled⁽¹⁾. In France, the quality of life of RA patients treated with long-term biotherapy in real life has never been the subject of a specific study.

Methods: In partnership with two patients’ associations, a cross-sectional observational survey of RA patients treated with biologics since at least one year, with the aim of assessing their functioning (using the HAQ-DI⁽²⁾ questionnaire) and quality of life (EQ-5D⁽³⁾ questionnaire) on a daily basis was carried out. Treatment satisfaction and expectations have been also evaluated.

Results: A total of 504 RA patients have been included in the study (mean age = 62.4 years; 18% male and 82% female). The average RA duration was 19.2 years and the mean treatment period with biologics was 8 years. About 40% of patients received first-line biologic treatment and 30% received 2^nd– or 3^rd-line biologic treatment. When RA was poorly controlled with first-line treatment, patients changed their treatment every 3 years on average. Reasons for switching biologics included poor efficacy (60% of patients) and tolerance problems (31%). Hospitalization due to RA progression during the last 12 months were reported by 22% of patients in 1st line-treatment and by 32% of patients in 2nd line and more. Functional disability, particularly affecting manual activities of daily living, also increased with the number of treatment lines. In addition, more than 50% of the patients in professional activity had to adapt or change their activity because of their state of health. Regarding health perception, only 14% of patients were satisfied with their symptom improvement (scored 80 to 100 on a scale from 0 to 100). The average score was 63.5 (quite satisfying). In addition, whether on symptoms or well-being, only a third of patients were satisfied with their condition. If patients recognize the major contribution of biologics (average satisfaction score was 7.5/10), they are more than 80% to expect the arrival of new biologics to improve their quality of life.

Conclusion: Despite the major therapeutic progress achieved with biologics for the management of rheumatoid arthritis, the results of this survey conducted with patient associations demonstrate a persistent functional disability in patients with RA as well as a reduced quality of life. The level of expectation of these patients remains high concerning future therapeutic alternatives.

1. Gerhold et al. Rheumatology (Oxford). 2015, 54:1858-66.
2. Guillemin et al. Rev Rhum Mal Osteoartic. 1991, 58:459–65.
3. Perneger et al. Value Health. 2010, 13:631-5

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/quality-of-life-of-rheumatoid-arthritis-patients-treated-with-biologics/