Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: EQ-5D-3L is frequently used for evaluation of quality of life (QOL). However, there are several problems when using EQ-5L-3L. Evaluation using EQ-5L-3L might not properly reflect the health status of patients since patients can choose from only three levels (no problems, some problems, extreme problems). Another limitation is the ceiling effect, whereby a value of 1 for QOL means “complete health”. Recently, EQ-5D-5L was developed to resolve these problems. Few reports are available which assess both methods for evaluation of QOL in the context of rheumatoid arthritis (RA). This was a comparative study of EQ-5D-3L and EQ-5D-5L in patients with RA conducted using the IORRA cohort to examine the usefulness of the EQ-5D-5L.
Methods: The subjects were Japanese RA patients who participated in the IORRA survey in October 2016. QOL evaluation using EQ-5D-3L and EQ-5D-5L were conducted at the same time, and the following analyses were cross-sectionally examined. The difference in QOL value distribution between EQ-5D-3L and EQ-5D-5L was investigated. The QOL values of EQ-5D-3L and EQ-5D-5L were compared stratified by sex, age, RA disease duration, RA disease activity, dysfunction level, and medications (steroid use, methotrexate [MTX] use and biological DMARD [bsDMARD] use). Among RA patients who evaluated themselves as “complete health” using EQ-5D-3L, the percentage of the patients which did not satisfy “complete health” was investigated.
Results: A total of 5,023 RA patients were included in this study. Baseline clinical features in this cohort were as follows: 94% women; average age of 61 years old; mean RA disease duration: 15.7 years; average DAS28: 2.6; proportions of steroid, MTX and bsDMARD use: 27.2%, 77.0%, and 23.7%, respectively. The average (SD) values of QOL using EQ-5D-3L and EQ-5D-5L were 0.83 (0.18) and 0.85 (0.16), respectively. Although among RA patients who evaluated themselves as “1”, which means “no problems” using EQ-5D-3L in the 4 dimensions (mobility, self-care, usual activities, and anxiety/depression), most of the patients also evaluated themselves as “1” using EQ-5D-5L, while among RA patients who evaluated themselves as “1” using EQ-5D-3L for “pain/discomfort”, most of the patients evaluated themselves as “2” which means “some problems” using EQ-5D-5L. The average QOL value using EQ-5D-3L stratified by each clinical feature was lower than that using EQ-5D-5L regardless of patients’ backgrounds and medications. The percentage of RA patients who evaluated themselves as “complete health” which was scored as “1” in all 5 dimensions using EQ-5D-3L and EQ-5D-5L, were 45.0% and 32.3%, respectively. Among RA patients who evaluated themselves as “complete health” using EQ-5D-3L, 28.2% were omitted from “complete health” using EQ-5D-5L. The dimension of “pain/discomfort” had the most influence on omission from “complete health”.
Conclusion: The problem of ceiling effect was improved by using EQ-5D-5L in RA patients, and was especially influenced by the dimension of “pain/discomfort”, suggesting that the EQ-5D-5L questionnaire might properly reflect the health status of RA patients.
To cite this abstract in AMA style:Saka K, Tanaka E, Inoue E, Abe M, kawano M, Sugitani N, Sugano E, Ochiai M, Yamaguchi R, Shimizu Y, Sugimoto N, Ikari K, Nakajima A, Taniguchi A, Yamanaka H. Comparison of QOL Evaluation Using EQ-5D-3L and EQ-5D-5L in Japanese RA Patients: A Study Using the IORRA Cohort [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/comparison-of-qol-evaluation-using-eq-5d-3l-and-eq-5d-5l-in-japanese-ra-patients-a-study-using-the-iorra-cohort/. Accessed September 26, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/comparison-of-qol-evaluation-using-eq-5d-3l-and-eq-5d-5l-in-japanese-ra-patients-a-study-using-the-iorra-cohort/