Poorer functionality is related to better quality of life response following the use of biological drugs: 6-month outcomes in a prospective cohort from the Public Health System (Sistema Único de Saúde), Minas Gerais, Brazil

Abstract

We aim to analyze factors associated with the quality of life (QOL) response of individuals with rheumatic diseases treated by the Public Health System (Sistema Único de Saúde) with biological disease-modifying antirheumatic drugs (bDMARDs). Data from 428 patients using bDMARDs were collected using a standardized form at baseline and 6 months after the onset of treatment. The average reduction of the scores on EuroQol-five dimension was 0.11 ± 0.18 6 months after the onset of treatment with bDMARDs, denoting significant improvement of the participants’ QOL. All the investigated types of disease exhibited significant improvement at the 6-month assessment, without any difference among them (p = 0.965). The participants with baseline poorest functionality and best QOL exhibited the best QOL outcomes after 6 months of treatment. Our study showed that the use of biological drugs induced considerable improvement in the participants’ QOL.

Keywords:

• biological drugs
• EQ-5D
• observational study
• Public Health System
• quality of life
• rheumatic diseases

Financial & competing interests disclosure

The authors were supported by the National Council for Scientific and Technological Development (CNPq). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Participants with rheumatoid arthritis (RA) exhibited statistically significant differences regarding concomitant use of medication and severity of disease compared with the remainder of the study population.

• Even in the case of established disease, with significant functional impairment and high disease activity, the participants exhibited considerable improvement following the use of biological disease-modifying antirheumatic drugs.

• The magnitude of quality of life improvement was similar across the sample as a whole as well as in the groups of patients with RA, PsA and ankylosing spondylitis.

• The participants with poorer functionality at baseline, as assessed by the HAQ-DI, exhibited greater quality of life improvement compared with the participants with better functional status at baseline.

• In Brazil, the Clinical Protocol and Therapeutic Guidelines (Protocolo Clínico e Diretrizes Terapêuticas) for RA [5] currently guide decision making as to medication; however, no similar protocols have yet been developed for ankylosing spondylitis and PsA.

• Although the EQ-5D has been sparsely used in individuals with rheumatic diseases, it has several advantages: it is easy to apply, it has been translated to and validated for many languages, and it requires only a short time for response.

• Future studies with larger cohorts should be conducted to validate and confirm the findings of this study.