Biological Therapy in Patients with Rheumatoid Arthritis in a Tertiary Center in Portugal: A Cross-Sectional Study

Authors

  • Melissa Fernandes Unidade de Doenças Auto-imunes/Medicina 7.2. Hospital de Curry Cabral. Centro Hospitalar Universitário de Lisboa Central. Lisboa.
  • Adelaide Figueiredo Unidade de Doenças Auto-imunes/Medicina 7.2. Hospital de Curry Cabral. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Serviço de Medicina IV. Hospital de Santarém. Santarém.
  • Ana Luísa Oliveira Unidade de Doenças Auto-imunes/Medicina 7.2. Hospital de Curry Cabral. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Serviço de Medicina I. Hospital José Joaquim Fernandes. Unidade Local de Saúde do Baixo Alentejo. Beja.
  • Ana Carolina Ferreira Unidade de Doenças Auto-imunes/Medicina 7.2. Hospital de Curry Cabral. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Serviço de Medicina Interna. Hospital do Divino Espírito Santo de Ponta Delgada. Ponta Delgada.
  • Pedro Mendonça Unidade de Doenças Auto-imunes/Medicina 7.2. Hospital de Curry Cabral. Centro Hospitalar Universitário de Lisboa Central. Lisboa. Serviço de Medicina. Hospital de Faro. Centro Hospitalar Universitário do Algarve. Faro.
  • Anna V. Taulaigo Unidade de Doenças Auto-imunes/Medicina 7.2. Hospital de Curry Cabral. Centro Hospitalar Universitário de Lisboa Central. Lisboa.
  • Madalena Vicente Unidade de Doenças Auto-imunes/Medicina 7.2. Hospital de Curry Cabral. Centro Hospitalar Universitário de Lisboa Central. Lisboa.
  • Maria João Fanica Serviços Farmacêuticos. Hospital de Curry Cabral.- Centro Hospitalar Universitário de Lisboa Central. Lisboa.
  • Carina Ruano Serviço de Radiologia. Hospital de Santo António dos Capuchos. Centro Hospitalar Universitário de Lisboa Central. Lisboa.
  • António Panarra Unidade de Doenças Auto-imunes/Medicina 7.2. Hospital de Curry Cabral. Centro Hospitalar Universitário de Lisboa Central. Lisboa.
  • Céu Mateus ivision of Health Research Lancaster University. Furness College. Lancaster.
  • Maria Francisca Moraes-Fontes Unidade de Doenças Auto-imunes/Medicina 7.2. Hospital de Curry Cabral. Centro Hospitalar Universitário de Lisboa Central. Lisboa. https://orcid.org/0000-0002-8917-6592

DOI:

https://doi.org/10.20344/amp.13605

Keywords:

Arthritis, Rheumatoid/drug therapy, Biological Products/therapeutic use, Biological Therapy, Quality of Life

Abstract

Introduction: Clinical outcomes in rheumatoid arthritis have greatly improved with therapeutic advances. Despite the availability of substantial clinical trial evidence, there is a lack of real-life data. The aim of this study was to assess disease status and quality of life in an outpatient population treated with biological disease-modifying anti-rheumatic drugs.
Material and Methods: Cross-sectional study recalling all patients ever treated in our unit with biological disease-modifying antirheumatic drugs. Clinical and demographic data, compliance, disease activity, functional status, joint deformities, and comorbidities were documented, and patients queried on occupational status, education, marital status and generic health related quality of life questionnaires.
Results: Recall was attended by 77 of the original 94 patients. At recall, median age was 63 years old, 82% of the patients were female and the median disease duration was 12 years. Biological therapy was started at a median of four years following disease onset. According to the disease activity score (DAS28), the percentage of patients with high, moderate, low disease activity or remission changed from 50, 45, 0 and 5 (pre-therapy) to 11, 37, 25 and 26 at recall, respectively; functional status was significantly improved. Seventy-five per cent of the patients retained the original treatment with good compliance. Lower Short Form-36 domain scores accompanied a low EQ-5D-3L score. Deceased patients (n = 6) had a lower estimated 10-year survival rate. In this group, biological therapy was discontinued at a higher frequency during follow-up.
Discussion: A high disease activity and a high HAQ disability index characterized most patients at pre-bDMARD onset.
Conclusion: Despite therapy switches and regular follow-up, a significant percentage of patients still presented with moderate disease activity, functional impairment and a poor health-related quality of life.

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Author Biography

Maria Francisca Moraes-Fontes, Unidade de Doenças Auto-imunes/Medicina 7.2. Hospital de Curry Cabral. Centro Hospitalar Universitário de Lisboa Central. Lisboa.

Maria Francisca Moraes-Fontes
MBBCh, Internal Medicine, PhD, FRCP(UK)
Unidade de Doenças Auto-Imunes do H. de Curry Cabral
Centro Hospitalar Lisboa Central
Rua Beneficência 8, 1069-166 Lisboa
Telephone: +351 21 792 4200, ext 74248

Cientista Convidada, Instituto Gulbenkian de Ciência
Professora afiliada NMS/FCM
ERN ReCONNET member

Published

2021-05-02

How to Cite

1.
Fernandes M, Figueiredo A, Oliveira AL, Ferreira AC, Mendonça P, Taulaigo AV, Vicente M, Fanica MJ, Ruano C, Panarra A, Mateus C, Moraes-Fontes MF. Biological Therapy in Patients with Rheumatoid Arthritis in a Tertiary Center in Portugal: A Cross-Sectional Study. Acta Med Port [Internet]. 2021 May 2 [cited 2022 Nov. 28];34(5):362-71. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13605

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Section

Original