The aim of this study was to assess the responsiveness to change of the quality of life evaluated by the EuroQol Five Dimensions Questionnaire (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) after biological treatment in a population of rheumatoid arthritis patients. A cohort of patients with RA (n = 29) treated with tocilizumab (TCZ) were analyzed in the study. The inclusion criteria were patients aged between 18 and 65 years, fulfilling American College of Rheumatology 1987 criteria for RA. All patients had inadequate response to methotrexate and with no prior biologic exposure. They were evaluated clinically including Disease Activity Score 28 (DAS28), and the European Quality of Life 5 Dimensions (EQ-5D) to measure the quality of life, and HAD assessed the anxiety and depression status at the initiation of treatment with anti-IL 6 receptor antibody agent and after 6 months. Sensitivity to change was quantified by the effect size (ES) before and after the treatment with TCZ. Among 29 patients with RA included in the study, 25 were females and 4 males. The mean age was 42 years ± 13.4 (SD). Three patients were excluded from the study before 24 weeks because of serious side effects, and five have missing data. The study population exhibited significant decreases in all measures of disease activity at 24 weeks. Physical activity expressed by the Health Assessment Questionnaire (HAQ) score increased through the observation period (for all p < 0.001). Sensitivity to change was high for the VAS and EQ-5D (ES 1.58 and 1.36, respectively) but only moderate for the HAD anxiety component (ES = 0.70) and small for the HAD depression component (ES = 0.4). The EQ-5D and VAS were more responsive than HADS to evaluate the quality of life on patient with RA treated with TCZ.
Background to evaluate the quality of life in women suffering from knee osteoarthritis, Consecutive outpatients consulting for primary knee OA were included in this cross sectional study. This study suggests a high impact of knee OA on all aspects of quality of live in women. Objectives We aimed to investigate the impact of knee osteoarthritis (OA) on the quality of life (QoL) in moroccan women patients with non-end-stage knee osteoarthritis. We suggest also to search possible factors associated with to health related QoL. Methods Patients consulting for primary knee OA were included. Most patients had an interviewer-administrated questionnaire. Functional status was assessed by womac and lequesne and QoL with the Moroccan version of OAKHQOL. Relationship between patients and disease features and the different domains of the OAKHQOL was evaluated by using Spearmann Correlation. The significant factors of related to the OAKHQOL were analyzed by a forward stepwise multiple regression model. Results: Table 1. Assessment of quality of life in patients with OA using OAKHOL ParametersPhysical activitiesMental healthPainSocial supportSocial functioning AgeNSNSNSNSNS Disease durationNSNSNSNSNS BMINSNS–0.323* <0.05NSNS BMINSNS–0.323* <0.05NSNS VAS pain–0.540**–0.432**–0.506**NSNS <0.001<0.002<0.001 Lequesne–0.605**–0.306*–0.689**NSNS 0.0010.04r <0.001 WOMAC–0.531**–0.564**–0.763**NSNS <0.001<0.001<0.001 Multiple linear regression models have shown that only WOMAC (-5.4 [-1.2-0.5]; p<0.001) and lequesne (3,1 [-1,2-4,9]; p<0.02) were significant independent factors related to QoL. Conclusions This study suggests a high impact of knee OA on all aspects of quality of live in women especially: physical activities, social support and social functioning. These disturbances re associated to poor functional status. Domains affected should be taken into account order to improve QoL in women with OA. These results should be confirmed by larger studies. Disclosure of Interest None Declared
Background Tocilizumab (TCZ) is a humanized anti-interleukin 6 (anti-IL 6) receptor antibody that has been demonstrated in previous clinical trials to improve rheumatoid arthritis (RA) and prevent radiographic progression. Musculoskeletal ultrasonography (MSUS) has increasingly been used as outcome measures in clinical trials of RA. Thus, we aimed to evaluate clinical and ultrasonographic (US) progression in RA patients treated with TCZ. Methods Twenty two consecutive patients, affected by RA [19 females, median age of 41 years (35,50), median disease duration of 72 months (36,171)] who were non-responders or partial responders to DMARDs therapy were commenced on Tocilizumab. The patients underwent clinical, laboratory, and assessment at baseline and after 6 months. The Disease Activity Score in 28 joints (DAS28) was recorded at inclusion and after a 6 months of therapy.The German ultrasound score included the following joints of the clinically dominant hand and foot: wrist, second and third metacarpophalangeal and proximal interphalangeal, and second and fifth metatarsophalangeal joints. Synovitis and synovial vascularity were scored semiquantitatively (grade 0–3) by gray-scale (GS) and power Doppler (PD) ultrasound. Clinical remission after 6 months of treatment was defined when DAS 28 was <2.6. Results At baseline, the median DAS28 score was 5.2 (4.4, 6.2) and the synovitis scores were 9.5 (6.7, 15) in GS ultrasound and 2.5 (0,7.2) in PD ultrasound. After 6 months of therapy, the DAS28 significantly decreased to 1.6 (0.8,2.4); p<0.001 and the GS and PD ultrasound scores significantly decreased to respectively 5 (4,6); p=0.001 and to 0.5 (0,1.7); p=0.04. Remission at 6 months was noted in 70% of patients. Conclusions This study indicates good evolution of RA patients under TCZ on basis on clinical and ultrasonographic findings. These results should be verified by further studies. Disclosure of Interest None Declared
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