scholarly journals Effectiveness of Tocilizumab after switching from intravenous to subcutaneous formulation in patients with rheumatoid arthritis: A single-centre experience

2021 ◽  
Vol 38 (3) ◽  
pp. 247-256
Author(s):  
Sonja Stojanović ◽  
Bojana Stamenković ◽  
Jovan Nedović ◽  
Ivana Aleksić ◽  
Jovana Cvetković
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Drug Administration ◽  
Joint Destruction ◽  
Drug Formulation ◽  
Life Assessment ◽  
Drug Effectiveness ◽  
Therapeutic Modalities ◽  
Number Of Patients

Nowadays, the appropriate control of rheumatoid arthritis (RA) involves the absence of clinical disease activity, delaying joint destruction as long as possible and adequate quality of life of the affected. With currently available therapeutic modalities, this therapeutic goal can be achieved in a large number of patients. The aim of this research was to determine the effectiveness of an IL-6 blocker (Tocilizumab) in patients with RA in everyday clinical practice. We also analyzed whether a change in the mode of drug administration (switching from intravenous to subcutaneous drug formulation) had an impact on drug effectiveness (using the DAS 28 SE and CDAI indexes) and quality of life of patients with RA (HAQ, Beck Depression Inventory, FACIT F score and SF 36 questionnaire). The study included 53 subjects diagnosed with RA, treated with Tocilizumab. After a six-month use of subcutaneous Tocilizumab, we concluded that the method of drug administration did not have an impact on its effectiveness and on all the examined parameters of quality of life assessment.

scholarly journals Physical activity in established rheumatoid arthritis and variables associated with maintenance of physical activity over a seven-year period – a longitudinal observational study

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Ann Bremander ◽  
◽  
Karina Malm ◽  
Maria L. Andersson
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Physical Function ◽  
Activity Level ◽  
Tender Joint Count ◽  
Established Rheumatoid Arthritis ◽  
Unhealthy Lifestyle ◽  
Number Of Patients

Abstract Background A large number of patients with RA do not adhere to the recommended levels of physical activity to enhance health. According to EULAR recommendations, physical activity should be part of standard care in people with rheumatic diseases. There have been few larger studies on maintenance of physical activity over longer periods of time. The aim was to study self-reported physical activity levels over 7 years in patients with established rheumatoid arthritis (RA). In addition, to determine variables associated with maintenance or change of physical activity behavior. Methods Questionnaires were sent to the BARFOT cohort in 2010 (n = 1525) and in 2017 (n = 1046), and 950 patients responded to both questionnaires. Patients were dichotomized according to meeting MVPA recommendations (physically active at a moderate level ≥ 150 min/week or at an intense level ≥ 75 min/week) or not. Body mass index, smoking habits, tender joint count (TJC), swollen joint count (SJC), Patient Global Assessment (PatGA), pain intensity and distribution, fatigue, physical function (HAQ), health-related quality of life (EQ. 5D), comorbidities, and medical treatment were assessed. We used logistic regression analysis to study variables associated with maintenance and/or change of MVPA behavior. Results Forty-one per cent (n = 389) of the patients met MVPA recommendations on both occasions. Patients who met MVPA recommendations over 7 years were younger and a higher proportion were never-smokers. There was a negative association with being overweight or obese, having cardiovascular or pulmonary diseases, pain, fatigue, and physical function, whereas there was a positive association between QoL and maintaining MVPA recommendations. Similar factors were positively associated with a deterioration in physical activity level over time. Conclusions Maintenance of physical activity over a long period of time is challenging for patients with established RA. Reports of high quality of life supported maintenance of physical activity while disease related and unhealthy lifestyle factors had a negative effect. Health professionals should consider the patient’s standpoint when encouraging maintenance of physical activity, preferably using coordinated lifestyle interventions.

scholarly journals AB0276 DIFFERENCES BETWEEN IMPACT OF BIOLOGICAL THERAPY AND IMPACT OF CONVENTIONAL TREATMENT ON PRODUCTIVITY AND QUALITY OF LIFE IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1437.2-1437
Author(s):  
M. Bogojevic ◽  
N. Miketic ◽  
S. Aligrudic ◽  
R. Medjedovic ◽  
D. Loncar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Work Ability ◽  
Conventional Therapy ◽  
Biological Therapy ◽  
Emotional State ◽  
Health Condition ◽  
Number Of Patients ◽  
Sf 36

Background:Number of patients with rheumatoid arthritis in Montenegro amounts around 3,000, while 8% of them are on biological therapy. This percent is similar, or even higher in comparison to countries that are highly comparable to Montenegro. However, the percentage is still lower than in European countries.Objectives:Objective of the study was to identify the differences between impact of biological and conventional therapy on quality of life of RA patients, their work ability and productivity, mental health, emotional state and social inclusion.Methods:The analysis was based on data gathered from the questionnaires filled by RA patients in Montenegro: 92 patients treated with biological therapy and 78 treated with conventional therapy. More insights and information from examined patients were gathered on two focus groups. Following indicators were used in the study: two indicators that measure work ability and productivity: one monetized – Work Productivity and Activity Impairment Questionnaire General Health V2.0 (WPAI-GH) and one non-monetized – RA Work Instability Scale (RA WIS), and two indicators that measure quality of life – Health Assessment Questionnaire (HAQ-DI) and RAND 36-Item Health Survey (SF-36).Results:WPAI-GH results are used in evaluation of absenteeism and presentism costs per RA patient per annum, which are caused exclusively by rheumatoid arthritis. WPAI-GH results are presented in the following figure. Total cost of absenteeism and presenteeism of RA patients in Montenegro amounts to 3.8 million EUR per annum. Results of RA WIS indicator suggest that patients treated with biological therapy are characterized by low to moderate level of work instability, and patients treated with conventional therapy by moderate level. Patients treated with biological therapy have shown 25% lower level of work instability. HAQ-DI indicator shows that both groups of patients are characterized by mild difficulties to moderate disability in performing everyday activities. However, patients treated with conventional therapy deal with higher level of difficulties, even though their level of RA progression is lower, on average. SF-36 indicator shows that patients treated with conventional therapy have lower level of physical functioning, followed by 26% higher pain intensity. They are 25% more exposed to limitations due to physical health problems caused by RA, and 20% more to limitations due to emotional problems. Patients treated with biological therapy, on average, rate their health with 50% higher rank in comparison to subjective health rate of patients treated with conventional therapy. They also feel that their health has improved during the past year, or stayed approximately the same, while patients treated with conventional therapy feel that their health condition has aggravated, or stayed unchanged.Conclusion:Results show that health condition, emotional state and life quality are better among the patients treated with biological therapy. Also, their productivity is higher compared to patients treated with conventional therapy. This conclusion is additionally supported by the fact that there is more progression of disease among RA patients treated with biological therapy, as well as by the fact that the average duration of RA is almost two times longer among examinees who are on biological therapy than among examinees who are on conventional therapy. Accordingly, access to biological therapy for greater number of patients in earlier stage of disease would result in reduction costs of lost productivity and work disability connected to RA, as well as in mitigation of RA impact on lives and functionality of patients.Figure 1.WPAI-GHDisclosure of Interests:None declared

scholarly journals Treatment strategy for patients with rheumatoid arthritis

2020 ◽  
Vol 63 (7) ◽  
pp. 422-430
Author(s):  
Soo-Kyung Cho ◽  
Yoon-Kyoung Sung
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Targeted Therapies ◽  
Functional Disability ◽  
Joint Destruction ◽  
Joint Damage ◽  
Chronic Inflammatory Disease ◽  
Biologic Dmards

Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting the joints, causing joint destruction, functional disability, and reduced quality of life in patients. The aim of RA treatment is to decrease the inflammation, prevent joint damage, and improve patientsʼ quality of life while minimizing progression of the disease. Both early detection and intervention with disease-modifying anti-rheumatic drugs (DMARDs) have been reported to improve therapeutic outcomes. Treatment with DMARDs should be started immediately after the diagnosis is established, with methotrexate as the best initial drug of choice. Disease activity should be regularly monitored. Targeted therapies can be considered in patients with persistent active disease despite methotrexate therapy. Remission or low disease activity is the preferred treatment target. There are two major classes of DMARDs: conventional synthetic DMARDs and the targeted therapies specific to pro-inflammatory cytokines including biologic DMARDs and small molecule inhibitors. Recently, the importance of shared decision making, in which patients and clinicians make decisions together, and education of the patient has been emphasized in the treatment strategies of RA. This review summarizes the effectiveness and safety of the DMARDs currently available for RA treatment. Recommendations for RA management would also be discussed in this article.

scholarly journals Clinical and Translational Research Challenges in Biliary Tract Cancers

2020 ◽  
Vol 27 (29) ◽  
pp. 4756-4777 ◽  
Author(s):  
Angela Lamarca ◽  
Melissa Frizziero ◽  
Mairéad G. McNamara ◽  
Juan W. Valle
Keyword(s):  
Quality Of Life ◽  
Translational Research ◽  
Biliary Tract ◽  
Basic Research ◽  
Life Assessment ◽  
Biliary Tract Cancers ◽  
Main Challenge ◽  
Number Of Patients ◽  
Clinical And Translational Research

Background: Biliary Tract Cancers (BTC) are rare malignancies with a poor prognosis. There are many challenges encountered in treating these patients in daily practice as well as in clinical, translational and basic research. Objective: This review summarises the most relevant challenges in clinical and translational research in BTCs and suggests potential solutions towards an improvement in quality of life and outcomes of patients diagnosed with such malignancies. Findings: The main challenge is the low number of patients with BTCs, complicated by the aggressive natural behaviour of cancer and the lack of funding sources for research. In addition, the clinical characteristics of these patients and the specific cancer-related complications challenge clinical research and clinical trial recruitment. It is worth highlighting that BTCs are a group of different malignancies (cholangiocarcinoma, gallbladder cancer and ampullary cancer) rather than a unique homogeneous disease. These subgroups differ not only in molecular aspects, but also in clinical and demographic characteristics. In addition, tailored imaging and quality of life assessment are required to tackle some of the issues specific to BTCs. Finally, difficulties in tissue acquisition both in terms of biopsy size and inclusion of sufficient tumour within the samples, may adversely impact translational and basic research. Conclusion: Increasing awareness among patients and clinicians regarding BTC and the need for further research and treatment development may address some of the main challenges in BTC research. International collaboration is mandatory to progress the field.

scholarly journals INSOMNIA CORRECTION WITH SYNTHETIC MELATONIN IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
pp. 8-18
Author(s):  
L.N. Gumenyuk ◽  
E.V. Sarchuk ◽  
N.A. Androshchuk
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Visual Analog Scale ◽  
Severity Index ◽  
Life Assessment ◽  
Analog Scale ◽  
Insomnia Severity Index ◽  
Sf 36 ◽  
Insomnia Severity

One of the features of rheumatoid arthritis, as a multiple-factor disease, is the presence of somnological disorders. The aim of the paper is to study the efficacy of synthetic melatonin in insomnia correction and melatonin effect on clinical parameters and quality of life in patients with rheumatoid arthritis. Materials and Methods. The study involved 89 patients, aged 18–45 years old with verified rheumatoid arthritis. The authors used a questionnaire technique to identify subjective sleep quality, the Insomnia Severity Index; Ritchie index, Visual analog scale; TSQM1.4; MOS SF-36. Results. The use of synthetic melatonin for insomnia correction in patients with rheumatoid arthritis improves the basic sleep characteristics. The most pronounced changes were observed in the following parameters “quality of sleep”, “duration of sleep” and “frequency of nocturnal awakenings”; positive dynamics of the Ritchie index: reduction of morning stiffness, severity of articular and algetic index. High values of treatment persistence can be considered as significant results of the study. In the course of treatment, there was a significant improvement in the indicators of psycho-emotional status, vitality and algia impact on daily activities. There was a tendency towards a decrease in the quality of life assessment due to the reversed insomnia 30 days after the end of therapy. Conclusion. The use of synthetic melatonin in patients with rheumatoid arthritis improves the basic sleeping characteristics, indirectly affects the basic clinical manifestations of the underlying disease and improves the quality of life. At the same time, the therapeutic effect is short-term: the results of dynamic monitoring of the quality of life 30 days after the end of therapy indicated a decrease in both mental and physical components, which was caused by the reversed insomnia and, as a consequence, a general deterioration in the somatic and mental state. Keywords: rheumatoid arthritis, insomnia, synthetic melatonin, treatment. Одной из особенностей ревматоидного артрита как полифакторного с точки зрения характера клинических проявлений заболевания является наличие сомнологических нарушений. Цель – изучение эффективности синтетического мелатонина в коррекции инсомнии и его влияния на клинические показатели и качество жизни больных ревматоидным артритом. Материалы и методы. В исследовании приняли участие 89 больных в возрасте от 18 до 45 лет c верифицированным ревматоидным артритом. В работе использовали анкетную методику выявления субъективных характеристик сна, опросник Insomnia Severity Index; индекс Ричи, Visual analog scale; опросник TSQM1.4; MOS SF-36. Результаты. Применение синтетического мелатонина для коррекции инсомнии у больных ревматоидным артритом позволяет улучшить основные характеристики сна. Наиболее выраженные изменения наблюдались по параметрам «качество сна», «продолжительность сна» и «частота ночных пробуждений»; по показателям индекса Ричи (сокращение продолжительности утренней скованности, выраженности суставного и алгического индекса). Значимым результатом исследования можно считать высокие значения приверженности терапии. На фоне лечения достоверно улучшились показатели психоэмоционального статуса, жизненной активности и влияния алгии на повседневную деятельность. Через 30 дней после завершения терапии регистрировалась тенденция к снижению оценки качества жизни, обусловленному реверсированием инсомнии. Выводы. Применение синтетического мелатонина у больных ревматоидным артритом позволяет улучшить основные характеристики сна, опосредованно влияет на базовые клинические проявления основного заболевания и способствует повышению уровня качества жизни. В то же время терапевтический эффект является краткосрочным: результаты динамического мониторинга качества жизни спустя 30 дней после завершения терапии свидетельствовали о снижении как психического, так и физического компонента, что преимущественно было обусловлено реверсированием инсомнии и, как следствие, общим ухудшением сомато-психического состояния. Ключевые слова: ревматоидный артрит, инсомния, синтетический мелатонин, лечение.

scholarly journals AB0127 COMBINATION THERAPY WITH METHOTREXATE AND QUALITY OF LIFE IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1092.2-1092
Author(s):  
S. Abdellaoui ◽  
S. Lefkir
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Combination Therapy ◽  
Joint Destruction ◽  
Social Activity ◽  
Sf 36 ◽  
Significant Difference ◽  
The Mean ◽  
Disease Modifying

Background:The level of quality of life in patients with rheumatoid arthritis (RA) is often overlooked. These patients suffer from an often-precarious quality of life resulting in pain, joint destruction and fatigue.Objectives:The main objective of this study was to compare the level of quality of life in patients with RA receiving treatment with disease-modifying anti-rheumatic drugs (DMARDs): monotherapy (biological only) versus combination therapy with methotrexate.Methods:We performed a descriptive study of 56 patients with RA meeting the criteria of the ACR 2010. The SPSS.20 software was used for statistical analyses.Results:These were 56 patients: 93% women and 7% men, mean age 46.74 years with an average duration of the disease of 14.74 years. 28 patients were on rituximab, 19 patients on tocilizumab and 9 patients on TNFi. The mean HAQ was 1.11. 52.38% of patients were on biological alone as monotherapy. The Compliance Questionnaire Rheumatology score (CQR19) was 55.15 / 100, the RAID (Rheumatoid Arthritis Impact of Disease) score was 3.08 / 10, the SF36 of 56.01 / 100, the AIMS score of 2.10 / 10 for social activity, 2.44 / 10 for pain, 3.32 / 10 for depression and 4.06 for physical activity.The comparison between the 2 groups (Combination therapy vs monotherapy) did not find any significant difference in terms of quality of life parameters: An SF-36 score> 55 was found in 56% in patients on combination therapy vs. 44% on monotherapy, the RAID score was 3.02 vs. 3.12, AIMS social activity 2.08 vs 2.13, AIMS pain 2.33 vs 2.59, AIMS activity physics of 4 vs 4.11.Conclusion:Our study did not demonstrate any superiority of the combination with methotrexate in improving quality of life. The use of biotherapy in patients with RA has been shown to be an important pharmacological strategy for the overall management of the disease.References:[1]Lavielle.M and Dougados.M. Targeted therapies in rheumatoid arthritis: Combination with conventional synthetic disease modifying antirheumatic drugs or monotherapy? Jone Bone Spine 2018; 85:3-9.Disclosure of Interests:None declared

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