Session Title: Clinical Practice/Patient Care
Session Type: Abstract Submissions (ARHP)
Biologics significantly improve disease activity of rheumatoid arthritis (RA), however, patient global assessment (PGA) is not always improved in parallel with disease activity scores. Though the 2011 ACR/EULAR definitions of remission criteria for RA adopt Boolean-based definition, there are few reports analyzing health status and patient satisfaction in the view of PGA for patients with RA treated with biologics.
To assess the correlation between each component of health status including patient satisfaction and Boolean-based definition of PGA remission for RA, patients newly treated with biologics were investigated for 24 weeks.
Methods: Patients with RA treated with 8 mg/kg of tocilizumab (TCZ) every 4 weeks, 3mg/kg of infliximab (IFX) at 0, 2, 6 weeks and thereafter every 8 weeks, 25mg of etanercept (ETN) twice a week were participated in this study. Health status with Arthritis Impact Measurement Scale 2 (AIMS-2), disease activity scores (tender joint count (TJC), swollen joint count (SJC), PGA and evaluator global assessment (EGA) on visual analogue scale (VAS), DAS28-CRP, SDAI, and CDAI) were assessed at week 0 and week 24. Comparison analysis of health status was performed between the patients who achieved the remission criteria of PGA (PGA�=<1cm) and those who did not. The data analysis was performed utilizing Wilcoxon rank sum test.
Sixty-six patients newly treated with biologics (TCZ: 39, IFX: 16, ETN: 11) were participated. Baseline characteristics were as follows: mean±SD of age (54.6±11.7 years), duration (6.7±7.2 years), SJC (10.9±7.5), TJC (10.8±6.1), PGA (5.4±2.4cm), EGA (5.5±2.1cm), CRP (2.4±2.6mg/dl), DAS28-CRP (5.3±1.3), SDAI (35.0±15.9), and CDAI (33.0±14.7), respectively. Twenty-seven of 66 patients (40.9%) achieved PGA remission. At baseline, there were no significant differences in age, duration, SJC, TJC, PGA, EGA, CRP, DAS28, SDAI, CDAI, or components of AIMS-2 between PGA remission and non-remission groups. At week 24, SJC, TJC, EGA, DAS28-CRP, SDAI, and CDAI were significantly lower in PGA remission group. At week 24, among health status, physical function, symptom, and role of AIMS-2 were significantly improved in PGA remission group compared with non-remission group. At week 24, patient satisfactory scores were significantly improved in PGA remission group except social interaction. Only the patient satisfactory scores for household and role (work) were significantly higher in PGA remission group compared with non-remission group at baseline.
For the patients with lower satisfactory scores in household and role (work) of health status at baseline, it is considered difficult to achieve PGA remission even when treated with biologics. Social interaction is not improved even when PGA remission is achieved. Therefore, nurses caring patients with RA are expected to assist patients to understand the importance of early treatment, support social activity, and set proper goal of treatment by evaluating health status.
« Back to 2012 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/optimizing-care-for-patients-with-rheumatoid-arthritis-newly-treated-with-biologics-by-evaluating-health-status-with-aims-2/