生物制剂对克罗地亚类风湿关节炎患者报告的生活质量结局（WHOQOL-BREF）、功能评分和疾病活动的影响：我们的经验。

Influence of Biological Therapeutics on Patient-Reported Quality-Of-Life Outcomes (Whoqol-Bref), Functional Scores and Disease Activity among Croatian Patients with Rheumatoid Arthritis: Our Experience.

机构信息

Division of Clinical Immunology, Allergology and Rheumatology, Department of Internal Medicine, School of Medicine, University of Zagreb, Dubrava University Hospital, Av. Gojka Šuška 6, 10040 Zagreb, Croatia,

出版信息

Psychiatr Danub. 2020 Nov;32(Suppl 4):547-552.

PMID:33212462

Abstract

BACKGROUND

Rheumatoid arthritis (RA) is a chronic and disabling disease with a great impact on the quality of life (QOL). The aim of this study was to assess QOL and health in RA patients treated with biological disease-modifying drugs (bDMARDs) as opposed to those treated with conventional synthetic DMARDs (csDMARDs). We analysed four domains of QOL: physical health (D1), mental health (D2), social relationships (D3) and one's surroundings (D4); as well as general quality of life (W1), general state of health (W2), and disease activity and physical disability.

SUBJECTS AND METHODS

Seventy-seven RA patients (group A=29 on bDMARDs, group B=48 on csDMARDs) were enrolled in the study. QOL was evaluated using WHO questionnaire (WHOQOL-BREF), disease activity using Disease Activity Score 28C-reactive protein (DAS28CRP) and functional status using Health Assessment Questionnaire (HAQ).

RESULTS

There was no statistically significant difference of mean values in the four domains of QOL, nor in the general QOL, between groups A and B. There was also no statistically significant difference regarding RA activity (3.51 vrs 3.54, p=0.56). However, we have found that the variable of the general state of health domain was statistically significantly higher in group B (2.66 vrs 2.89, p=0.001), while HAQ was statistically significantly higher in group A (1.19 vrs 1.07, p=0.018), as well as the duration of RA (6.25vrs 3.75 years, p=0.0006). Statistically significant correlation was found between HAQ and W2, disease duration and D3 in group A and DAS28CRP and D1, D2, W2 and HAQ and D1 and D2 in group B.

CONCLUSION

These findings suggest that the inclusion of bDMARDs in the treatment regimen was overdue, with RA already advancing with developed functional disability, which prevented the achievement of the primary goals of treatment: low disease activity or remission and the improvement of patient's QOL.

摘要

背景

类风湿关节炎（RA）是一种慢性且使人丧失能力的疾病，对生活质量（QOL）有重大影响。本研究的目的是评估接受生物疾病修饰药物（bDMARDs）治疗的 RA 患者与接受传统合成 DMARDs（csDMARDs）治疗的患者的 QOL 和健康状况。我们分析了 QOL 的四个领域：身体健康（D1）、心理健康（D2）、社会关系（D3）和周围环境（D4）；以及一般生活质量（W1）、一般健康状况（W2）以及疾病活动度和身体残疾度。

受试者和方法

本研究纳入了 77 名 RA 患者（A 组=29 名接受 bDMARDs 治疗，B 组=48 名接受 csDMARDs 治疗）。使用世界卫生组织问卷（WHOQOL-BREF）评估 QOL，使用 28 个 C 反应蛋白疾病活动评分（DAS28CRP）评估疾病活动度，使用健康评估问卷（HAQ）评估功能状态。

结果

A 组和 B 组在四个 QOL 领域以及一般 QOL 方面的平均值均无统计学差异。RA 活动度也无统计学差异（3.51 vrs 3.54，p=0.56）。然而，我们发现 B 组的一般健康状况域变量明显更高（2.66 vrs 2.89，p=0.001），而 A 组的 HAQ 明显更高（1.19 vrs 1.07，p=0.018），RA 病程也更长（6.25 vrs 3.75 年，p=0.0006）。A 组中 HAQ 与 W2、病程与 D3 之间以及 B 组中 DAS28CRP 与 D1、D2、W2 和 HAQ 以及 D1 和 D2 之间存在统计学显著相关性。