Rheumatoid arthritis in real clinical practice: initiation of therapy with biological agents. Results of the «Computer Terminals of Self-Assessment for Patients with Rheumatic Diseases» («TERMINAL-II») project
| Autor: | V. N. Amirdzhanova, E. Yu. Pogozheva, A. E. Karateev, O. V. Antipova, I. B. Vinogradova, A. Yu. Kazankova, R. G. Mukhina, A. G. Vasilyev, O. B. Nesmeyanova, E. A. Bogdanova, R. R. Samigullina, A. A. Vasilenko, I. B. Bashkova, T. S. Salnikova, I. N. Dashkov, N. E. Nikulenkova, V. Yu. Manokhin, I. P. Afanasyeva, O. N. Anoshenkova, T. V. Plaksina, M. R. Spitsina, L. V. Solodovnikova, A. V. Petrov, O. P. Slyusar, E. V. Papichev, E. V. Ivanova, L. V. Masneva, L. P. Evstigneeva, I. V. Kolotilina, E. N. Otteva, I. A. Cherentsova, I. N. Shchendrygin, S. A. Derevenskikh, I. G. Bannikova, N. K. Delyavskaya, I. N. Danilova, I. M. Marusenko |
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| Jazyk: | ruština |
| Rok vydání: | 2019 |
| Předmět: |
rheumatoid arthritis
medicine.medical_specialty Immunology Population chemistry.chemical_compound Tocilizumab Rheumatology Quality of life Internal medicine medicine Adalimumab Immunology and Allergy Pharmacology (medical) education education.field_of_study business.industry Abatacept medicine.disease chemistry quality of life Rheumatoid arthritis biological agents Cohort Medicine Methotrexate business medicine.drug |
| Zdroj: | Современная ревматология, Vol 13, Iss 3, Pp 30-38 (2019) |
| ISSN: | 1996-7012 |
| Popis: | Objective : to assess quality-of-life (QoL) dynamics in patients with rheumatoid arthritis (RA) when initiating therapy with biological agents (BAs) in real clinical practice. Patients and methods . The investigation enrolled patients with RA from the patient cohort participating in the TERMINAL-II multicenter Russian study, who newly initiated BA therapy. In the self-assessment terminal, the patient completed HAQ, EQ-5D, and RAPID-3 questionnaires. DAS28, SDAI, CDAI, and RAPID-3 were used to determine disease activity. The patient's functional status and QoL were assessed using the HAQ index and the EQ-5D questionnaire, respectively. The efficiency of the therapy was analyzed 6 months after the start of the study according to the standard procedures. Results and discussion . The investigation enrolled 156 RA patients: 79.6% females; mean age, 45.8±13.2 years; disease duration, 7.6±5.6 years. The patients had high RA activity (a mean DAS28 of 5.2±1.2, a mean SDAI of 39.5±16.4, a mean CDAI of 27.5±10.4, and a mean RAPID-3 of 15.1±3.6) and previous inefficacy of synthetic disease-modifying antirheumatic drugs (DMARDs) after at least 6 months of therapy. Only 1.2% of patients had a good functional status comparable to the population-based control (HAQ 40.5). 70% of patients needed to take non-steroidal anti-inflammatory drugs (NSAIDs). The first BA was chosen in accordance with the recommendations for administration of BAs and in terms of their availability in a specific region of the Russian Federation. The first prescribed BA was tumor necrosis factor-a (TNF-a) inhibitors in 112 (71.8%)patients, anti-B-cell therapy in 14 (9.0%), an interleukin-6 receptor inhibitor in 16 (10.3%), and a leukocyte costimulatory inhibitor in 14 (9.0%). Comparison of the patients receiving newly initiated therapy with TNF-a inhibitors and drugs with other mechanisms of action showed that the patients who had abatacept received higher doses of methotrexate (MTX), but lower doses of glucocorticoids (GCs) than those who were prescribed rituximab and tocilizumab. A statistically significant decrease in DAS28, SDAI, CDAI, and RAPID-3 scores was achieved after 6 months of therapy. Improvements of functional status and QoL in patients were also noted (p |
| Databáze: | OpenAIRE |
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