Quality of life of patients with rheumatoid arthritis under biological
               therapy

a longitudinal study, conducted from November 2010 to September 2011, with implementation of the instruments HAQ II (health assessment questionnaire) and SF-36 (medical outcomes short-from health survey). Barlett test, Anova, Friedman and paired t-test were performed for multiple extracts.

Results:

30 patients were evaluated, mean age of 47.6 (SD: 12.25) years and prevalence of females (90%). The mean score of HAQ II before treatment was 1.97, with significant reduction of up to 1.23 after six months of biological therapy (p<0.01). Most of the SF-36 domains showed significant improvement after six months of treatment (p<0.01), highlighting the social aspects, pain, physical functioning, emotional issues, vitality and physical aspects.

Conclusion:

the use of biologic therapy in patients with RA refractory to standard therapies proved to be an important pharmacological strategy for improving HRQL.

Keywords:
rheumatoid arthritis; biological therapy; quality of life; rheumatology; rheumatic diseases

Characteristics		n (%)
Age (years)		47,63 (±12,25)
	>20 - 30	2 (6.7%)
	>30 - 40	7 (23.3%)
	>40 - 50	6 (20.0%)
	>50 - 60	13 (43.3%)
	>60	2 (6.6%)
Gender
	Male	3 (10.0%)
	Female	27 (90.0%)
Education
	Illiterate	1 (3.3%)
	Basic education	9 (30.0%)
	High school	14 (46.7%)
	Higher education	3 (10.0%)
	Postgraduate	3 (10.0%)
Current occupation
	On medical leave	3 (10.0%)
	Retired	1 (3.3%)
	Retired for disability	6 (20.0%)
	Housewife	7 (23.3%)
	Working	13 (43.3%)
Marital status
	Married	12 (40.0%)
	Divorced	2 (6.7%)
	Single	14 (46.7%)
	Widowed	2 (6.7%)
Household income
	01 minimum wage	6 (20.0%)
	02-05 MW	15 (50.0%)
	06-10 MW	5 (16.7%)
	More than 10 MW	4 (13.3%)
International classification of diseases (ICD-10) ^* * M05 (positive for RA); M06 (negative for RA)
	M05	20 (66.7%)
	M06	10 (33.3%)
Duration of diagnosis
	1 to 2 years	5 (16.7%)
	3 to 5 years	8 (26.7%)
	5 years or more	16 (53.3%)
Rheumatoid factor
	Negative	10 (33.3%)
	Positive	20 (66.7%)
Physiotherapy
	No	27 (90.0%)
	Yes	3 (10.0%)

Questionnaires	Baseline (I)	3 months (II)	6 months (III)	Comparisons (p values)^* * Paired t-test for multiple extracts (evaluating mean differences) p <0.05.
Questionnaires	Baseline (I)	3 months (II)	6 months (III)	I x II	I x III	II x III
HAQ II	1.97 (0.66)	1.21 (0.73)	1.23 (0.74)	2.2e-07	3.0e-06	1
SF-36 (domains):
Functional capacity	31.33 (23.74)	51.33 (28.74)	53.67 (26.81)	4.3e-05	3.2e-05	0.56000
Limitations due to physical issues	18.33 (34.70)	53.33 (43.42)	57.50 (45.08)	0.00019	7.6e-05	0.60859
Pain	31.57 (24.08)	55.17 (29.08)	52.20 (29.14)	2.2e-06	0.00051	0.62834
Overall health	45.97 (20.63)	59.20 (20.53)	53.80 (26.04)	0.00820	0.33680	0.16841
Social aspects	48.75 (26.13)	64.17 (26.00)	70.83 (28.30)	0.00660	0.00014	0.11080
Vitality	46.83 (24.01)	58.17 (21.99)	54.50 (25.03)	0.0615		0.36132
Limitations due to emotional issues	30.00 (40.45)	57.78 (47.89)	72.22 (42.96)	0.00626	0.00012	0.08500
Mental health	52.40 (22.27)	64.93(23.99)	60.53 (27.41)	0.00800	0.12800	0.24162

Questionnaire	Baseline	6 months
HAQ II	n %	n %
Mild disability (HAQ II de 0 a 1)	2 (6.7%)	14 (46.7%)
Moderate disability (HAQ II >1 a 2)	15 (50%)	12 (40%)
Severe disability (HAQ II >2 a 3)	13 (43.3%)	4 (13.3%)

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

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[1] * Correspondence: Address: Av. José Sá Maniçoba, s/n Centro, Petrolina, PE – Brazil Postal Code: 56.304-917 Phone: (87) 2101-6862 andre.santoss@univasf.edu.br