Neycheva Stefka, Naseva Emilia, Batalov Zguro, Karalilova Rositsa, Batalov Anastas
Department of Rheumatology, Military Medical Academy, MHAT-Sofia, 3 Sveti Georgi Sofiyski Str., 1606, Sofia, Bulgaria.
Faculty of Public Health "Prof. Tsekomir Vodenicharov, MD, DSc", Medical University of Sofia, 8 Byalo More Str., 1527, Sofia, Bulgaria.
Rheumatol Int. 2023 Jul;43(7):1287-1296. doi: 10.1007/s00296-023-05327-0. Epub 2023 Apr 19.
The advent of biologic disease-modifying antirheumatic drugs has dramatically changed the comprehensions of treatment and long-term prognosis in patients with rheumatoid arthritis. The potent therapeutic results can only be achieved if the patients adhere to prescribed medications. The objective of this study was to estimate the impact of age, gender, duration of the disease, concomitant Methotrexate therapy, prior exposure to biologic agents, disease activity, functional capacity, and health-related quality of life on adherence to biologic treatment among Bulgarian population with rheumatoid arthritis. This was a retrospective observational cohort study that included 179 patients. At the baseline visit and subsequent follow-up assessments at 6, 12, 24 and 36 months, patients were interviewed by a physician and underwent physical examinations. We monitored the changes in disease activity, functional capacity and health-related quality of life on each time point. Univariate and multivariate binary logistic regression was used to determine the prognostic value of possible predictors of treatment adherence. Our findings showed that only DAS28 score [odd ratio (OR) = 1.174; 95% CI 1.74-2.362] and HAQ score (OR 2.803; 95% CI 1.428-5.503) remained significant for the treatment adherence throughout the study period. The adherence to the biologic disease-modifying anti-rheumatic drugs among Bulgarian patients with rheumatoid arthritis is suboptimal. A multifaceted and comprehensive knowledge of the influencing factors can be useful for the development of different strategies that can improve treatment adherence.
生物性抗风湿药物的出现极大地改变了对类风湿关节炎患者治疗及长期预后的理解。只有患者坚持按规定用药，才能取得显著的治疗效果。本研究的目的是评估年龄、性别、病程、同时使用甲氨蝶呤治疗、既往接触生物制剂情况、疾病活动度、功能能力以及健康相关生活质量对保加利亚类风湿关节炎患者生物治疗依从性的影响。这是一项回顾性观察队列研究，纳入了179例患者。在基线访视以及随后6、12、24和36个月的随访评估中，由医生对患者进行访谈并进行体格检查。我们在每个时间点监测疾病活动度、功能能力和健康相关生活质量的变化。采用单因素和多因素二元逻辑回归来确定治疗依从性可能预测因素的预后价值。我们的研究结果表明，在整个研究期间，只有疾病活动度评分（DAS28）[比值比（OR）=1.174；95%置信区间1.74 - 2.362]和健康评估问卷（HAQ）评分（OR 2.803；95%置信区间1.428 - 5.503）对治疗依从性仍具有显著意义。保加利亚类风湿关节炎患者对生物性抗风湿药物的依从性欠佳。全面了解影响因素有助于制定不同策略以提高治疗依从性。
