QL4 - ASSESSMENT OF QUALITY OF LIFE IN PATIENTS WITH METASTATIC MELANOMA IN REAL CLINICAL PRACTICE IN FRANCE

The article discusses the current state of the use of pharmacogenetic testing in clinical practice in the field of psychiatry, narcology and neurology in the Russian Federation. The active introduction of pharmacogenetic testing in clinical practice contributes to a personalized approach to predicting the pharmacological response to drugs, increasing the safety and effectiveness of pharmacotherapy, complience and the quality of life of patients with neuropsychiatric disorders. In the future, an increase in the availability of pharmacogenetic testing in real clinical practice is expected.

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The first experience of using upadacitinib in the treatment of rheumatoid arthritis in real clinical practice (results of the multicenter project “RACURS”)

Rheumatology Science and Practice ◽

10.47360/1995-4484-2021-571-577 ◽

2021 ◽

Vol 59 (5) ◽

pp. 571-577

Author(s):

V. N. Amirjanova ◽

A. E. Karateev ◽

E. Y. Pogozheva ◽

A. A. Baranov ◽

V. I. Mazurov ◽

...

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Clinical Practice ◽

Disease Activity ◽

Functional State ◽

High Disease Activity ◽

Efficacy And Safety ◽

Previous Therapy ◽

Real Clinical Practice

Upadacitinib (UPA), a JAK inhibitor, is a new therapeutic option that allows patients with insufficient response to therapy with basic anti-inflammatory drugs (DMARDs) or genetically engineered biological drugs (GEBDs) to achieve the goals of therapy for rheumatoid arthritis (RA). Despite the availability of convincing data from international randomized clinical trials, there is insufficient information about the efficacy and safety profile of UPA, the quality of life of patients receiving the drug in real clinical practice.Aim of the study – to assess the efficacy and tolerability of the UPA drug at a dose of 15 mg/day in patients with rheumatoid arthritis with moderate and high disease activity and to assess their quality of life in real clinical practice.Materials and methods. The study included 41 patients with RA with insufficient effect of previous therapy with DMARDs or GEBDs, persisting moderate or high disease activity, who were initiated with UPA therapy in 7 rheumatological centers of the Russian Federation. To assess the activity of the disease, standard indices were used: DAS28- ESR, DAS28-CRP, SDAI, CDAI. Functional ability was assessed according to the HAQ questionnaire, quality of life – according to the EQ-5D questionnaire, the activity of the disease according to the patient’s opinion – according to the RAPID-3 index. The HADS scale was used to identify the states of depression, anxiety and emotional disorder.Results. During the first week of taking the drug, there was a marked decrease in pain from 60 to 30 mm on a visual analogue scale, which lasted until the third month of therapy. There was a statistically significant decrease in morning stiffness, the number of painful and swollen joints, health assessments by the doctor and patient, erythrocyte sedimentation rate and C-reactive protein (p≤0.001). A decrease in disease activity was also noted according to the dynamics of the activity indices DAS28, SDAI, CDAI (p<0.001). The goals of therapy (remission or low disease activity) by the 3rd month of therapy according to the combined indices of activity DAS28-ESR and DAS28-CRP reached 44.8 and 63.4% of patients, respectively, according to the SDAI index – 56.7%, according to the CDAI index – 25.9%. A pronounced improvement in joint function (70% improvement according to the criteria of the American College of Rheumatology) was noted by 33.3% of patients, population indicators of functional state (HAQ≤0.5) had 15.8% of patients. The difference in the HAQ index by the 3rd month of therapy compared to the indicator before treatment was –0.60 points. The quality of life, assessed by patients using the EQ-5D questionnaire, improved in 98.5% of patients, with a 70% improvement noted in more than a third of them (41.7%). The drug was well tolerated, no adverse reactions were registered by the 3rd month of therapy, all patients continued treatment.Conclusions. The first results of the use of UPA in RA patients with insufficient efficacy of previous therapy with DMARDs or GEBDs in real clinical practice indicate its efficacy and safety, an improvement in the functional state and quality of life of patients by the 12th week of the study.

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Rheumatoid arthritis in real clinical practice. Results of the «Computer Terminals of Self-Assessment for Patients with Rheumatic Diseases» («TERMINAL-I») project

Modern Rheumatology Journal ◽

10.14412/1996-7012-2019-2-25-30 ◽

2019 ◽

Vol 13 (2) ◽

pp. 25-30 ◽

Cited By ~ 1

Author(s):

V. N. Amirdzhanova ◽

E. Yu. Pogozheva ◽

A. E. Karateev ◽

R. R. Samigullina ◽

O. B. Nesmeyanova ◽

...

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Clinical Practice ◽

Disease Activity ◽

Functional Status ◽

Disease Duration ◽

The Mean ◽

Real Clinical Practice

Objective: to describe the portrait of a patient with rheumatoid arthritis (RA) in real clinical practice, to assess disease activity from the point of view of a physician and a patient, functional status, quality of life (QOL), and the efficiency of the therapy performed.Patients and methods. The investigation enrolled 976 RA patients from a cohort of patients in the TERMINAL-I multicenter study, who, when visiting a rheumatologist, independently assessed the disease activity and QOL using a computer system (the «Computer Terminals of SelfAssessment for Patients with Rheumatic Diseases» project). The mean age of the patients was 52.30±13.3 years; women accounted for 85%; the median disease duration 8.0 [4.0; 14.0] years. Baseline clinical parameters and pharmacotherapy were evaluated for 6 months. The disease activity was determined by the DAS28 and RAPID-3 indices; functional status and quality of life were evaluated by the HAQ and the EQ-5D, respectively.Results. 83% of the RA patients were positive for rheumatoid factor and 60% were for anti-cyclic citrullinated peptide antibodies. There was a preponderance of patients with high (40.5%) and moderate (46.8%) RA activity; 6.9% were observed to have a low activity; 5.8% had clinical remission. The mean values of DAS28 and RAPID-3 were 4.7±1.3 and 13.7±3.6, respectively. Only 14.3% of patients had a good functional status that was comparable with the population-based control (HAQ≤0.5). The remaining patients were found to have a substantial decrease in joint functional parameters (median HAQ 1.88 [1.0; 2.5]) and EQ-5D QOL (0.60 [0.60; 0.74). Prosthetic joints were present in 7.4% of patients. At visit 1 to a rheumatologist, the therapy was changed in 15% of patients. During 6-month follow-up, conventional disease-modifying anti-rheumatic drugs were taken by almost all (91.2%) patients. Of them, 70.9% of the patients were treated with methotrexate (MTX): 77.0% received the latter at a dose of 15 mg/week and 23.0% had it at a dose of >15 mg (17.5 to 40 mg/week). Glucocorticoids could be stopped in 20.5% of the patients within six months. Tumor necrosis factor-α inhibitors and anti-B-cell therapy were used in 6.6 and 16.2% of patients, respectively. At 6-month follow-up (Visit 2), 54% of patients achieved a 20% clinical improvement in the ACR criteria. At the same time, the DAS28 scores decreased substantially from 4.5±1.2 to 3.8±1.1 (p = 0.0001). There was a minimal functional improvement in the HAQ index in 64% of patients and a better EQ-D QOL scores in 16%.Conclusion. The majority of RA patients who came to the rheumatologists showed high to moderate disease activity. This was due to long disease duration, inadequate MTX dose, and insufficient patient monitoring in real clinical practice. Introduction of a computer system for selfassessment of their health status by RA patients in an outpatient setting could improve the interaction of physicians, nurses, and patients, better monitor disease activity, and enhance therapeutic efficiency.

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Clinical efficacy of anti-ige-therapy in adult patients with severe uncontrolled bronchial asthma in real clinical practice

Medical Council ◽

10.21518/2079-701x-2018-15-54-58 ◽

2018 ◽

pp. 54-58

Author(s):

G. L. Ignatova ◽

E. V. Blinova ◽

O. L. Minakina

Keyword(s):

Quality Of Life ◽

Clinical Practice ◽

Bronchial Asthma ◽

Allergic Diseases ◽

Adult Patients ◽

Asthma Exacerbations ◽

Ige Mediated ◽

Real Clinical Practice

The article presents the results of comprehensive assessment of the efficacy of anti-IgE therapy in adult patients with severe IgE-mediated uncontrolled bronchial asthma in real clinical practice. Omalizumab added to the background anti-inflammatory therapy allowed to reduce the incidence of asthma exacerbations, achieve stable positive dynamics during severe asthma and associated allergic diseases, increase control of the disease, and improve the patients’ quality of life. The drug has a wellcharacterized long-term use safety profile.

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Effectiveness of netakimab in real clinical practice in patients with severe forms of psoriasis

Medical alphabet ◽

10.33667/2078-5631-2020-6-28-33 ◽

2020 ◽

pp. 28-33

Author(s):

A. A. Hotko ◽

L. S. Kruglova ◽

M. Yu. Pomazanova ◽

R. A. Hotko

Keyword(s):

Quality Of Life ◽

Clinical Practice ◽

Systemic Therapy ◽

Methotrexate Therapy ◽

Keratinocyte Differentiation ◽

Inflammatory Dermatoses ◽

Skin Symptoms ◽

Preferential Activation ◽

Real Clinical Practice

Psoriasis refers to genetically deterministic chronic inflammatory dermatoses, which are characterized by systemic immuno-mediated inflammatory response with preferential activation of the IL -23/-17 axis, growth deviation and keratinocyte differentiation.Material and methods. There were 21 patients under supervision with moderate to severe plaque psoriasis. Nine (42.8 %) patients did not receive previous systemic therapy; 3 (14.2 %) patients received apremilast at a dose of 30 mg twice a day during a year, 4 (19.0 %) patients were prescribed methotrexate at a dose of 15 mg subcutaneously weekly, for at least a year; 5 (23.8 %) patients received secukinumab at 300 mg subcutaneously once every 4 weeks for a year. All patients had a lost of effect or had developed side effects, which determined a change in therapeutic tactics.Results. Among the patients who were earlier not receiving treatment treatment after therapy with netakimab was started, the PASI index made 3.5 ± 1.1 (decrease by 94.4 %), the PASI index at the patients who were earlier receiving sekukinumab was 4.5 ± 1.1 (decrease by 81.9 %), among the patients who were earlier receiving the methotrexate the PASI index was 8.5 ± 1.3 (decrease by 89.9 %), at the patients who were earlier receiving apremilast the PASI index was 9.5 ± 2.1 (decrease by 86.3 %).Conclusions. Improvement in skin symptoms was accompanied by improvement of patients’ quality of life. Thus, the DLQI decreased by 77.9 % in the group of patients who had not previously received systemic therapy, by 77.4 % and 76.4 % in patients who had previously received sekukinumab and methotrexate therapy, respectively, and by 85.2 % in the group of patients who had previously received apremilast.

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Quality of life assessments in clinical practice using either the EORTC-QLQ-C30 or the SEIOQL-DW: a randomized study

Journal of Patient-Reported Outcomes ◽

10.1186/s41687-021-00315-z ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Åsa Kettis ◽

Hanna Fagerlind ◽

Jan-Erik Frödin ◽

Bengt Glimelius ◽

Lena Ring

Keyword(s):

Quality Of Life ◽

Clinical Practice ◽

Significant Difference ◽

Patient Reported ◽

Health Related Qol ◽

Health Related ◽

Secondary Outcomes ◽

The Impact ◽

Over Time

Abstract Background Effective patient-physician communication can improve patient understanding, agreement on treatment and adherence. This may, in turn, impact on clinical outcomes and patient quality of life (QoL). One way to improve communication is by using patient-reported outcome measures (PROMs). Heretofore, studies of the impact of using PROMs in clinical practice have mostly evaluated the use of standardized PROMs. However, there is reason to believe that individualized instruments may be more appropriate for this purpose. The aim of this study is to compare the effectiveness of the standardized QoL-instrument, the European Organization for Research and Treatment of Cancer Quality of Life C-30 (EORTC-QOL-C30) and the individualized QoL instrument, the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), in clinical practice. Methods In a prospective, open-label, controlled intervention study at two hospital out-patient clinics, 390 patients with gastrointestinal cancer were randomly assigned either to complete the EORTC-QOL-C30 or the SEIQoL-DW immediately before the consultation, with their responses being shared with their physician. This was repeated in 3–5 consultations over a period of 4–6 months. The primary outcome measure was patients’ health-related QoL, as measured by FACIT-G. Patients’ satisfaction with the consultation and survival were secondary outcomes. Results There was no significant difference between the groups with regard to study outcomes. Neither intervention instrument resulted in any significant changes in health-related QoL, or in any of the secondary outcomes, over time. This may reflect either a genuine lack of effect or sub-optimization of the intervention. Since there was no comparison to standard care an effect in terms of lack of deterioration over time cannot be excluded. Conclusions Future studies should focus on the implementation process, including the training of physicians to use the instruments and their motivation for doing so. The effects of situational use of standardized or individualized instruments should also be explored. The effectiveness of the different approaches may depend on contextual factors including physician and patient preferences.

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Health-Related Quality of Life Following Allogeneic Hematopoietic Stem Cell Transplantation

Hematology ◽

10.1182/asheducation-2010.1.248 ◽

2010 ◽

Vol 2010 (1) ◽

pp. 248-254 ◽

Cited By ~ 20

Author(s):

Margaret Bevans

Keyword(s):

Quality Of Life ◽

Stem Cell ◽

Clinical Practice ◽

Hematopoietic Stem Cell Transplantation ◽

Health Related Quality ◽

Hematopoietic Stem ◽

Allogeneic Hsct ◽

Related Quality ◽

Health Related

Abstract It is common knowledge that an allogeneic hematopoietic stem cell transplantation (HSCT) will have an enormous impact on the lives of transplant recipients and their families. Once an appropriate donor is identified, the curative potential of this treatment often drives the decision to proceed knowing that there will be intense physiologic toxicities and adverse effects on health-related quality of life (HRQL). Twenty-five years ago, HRQL was identified as an efficacy parameter in the evaluation of new anticancer drug therapy. Overall, the evidence suggests that an allogeneic HSCT has a significant impact on the overall HRQL of recipients, which is a result of decrements across all dimensions, including a significant symptom profile. The degree of impact on overall HRQL and the multiple dimensions varies across the transplant trajectory. Specific HRQL dimensions, such as physical function and symptoms, are easily incorporated into a clinician's assessment whereas other dimensions (eg, psychosocial) are less commonly integrated. The translation of HRQL results to improve clinical practice is not well established. Clinicians are often uncertain when to assess the scope of HRQL and how to interpret the information in a clinically meaningful way. The purpose of this review is to highlight the quality-of-life effects of allogeneic HSCT and discuss application into clinical practice.

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