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Reduced disease activity improved QoL in RA patients
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Tight control as a treatment strategy did not have an independent effect on the quality of life of patients with early rheumatoid arthritis; however, lowering disease activity clearly improved quality of life, according to study results.
Researchers in the Netherlands conducted the Computer Assisted Management of Early RA (CAMERA) trials in patients with early rheumatoid arthritis (RA) with disease duration of less than 1 year and no prior use of disease-modifying antirheumatic drugs. In the open-label CAMERA study, 299 patients were randomly assigned a methotrexate (MTX)-based tight control (TC) strategy or usual care. In the double blind, treat-to-target CAMERA II study, 236 patients were randomly assigned 10 mg/day prednisone or placebo added from initiation to an MTX-based TC strategy.
Researchers said randomization to TC resulted in lower disease activity in both trials.
The Influence of Rheumatic Diseases on General Health and Lifestyle questionnaire (IRGL) was used to assess patients’ quality of life (QoL) during both trials.
“Baseline and 1- and/or 2-year measurements were analyzed with IRGL (sub)scales as outcome variables and treatment strategy and disease activity assessing 28 joints [DAS28] as independent variables, correcting for baseline values of each scale and possible confounders (gender, age, rheumatoid factor status),” the researchers reported.
Neither strategy was clearly associated with QoL. DAS28 decrease, however, was associated with improvement in most QoL subscales except social well-being.
“Lowering disease activity was clearly associated with enhanced quality of life, irrespective of how this goal was reached,” the researchers concluded. “The present study results are compatible with guidelines recommending to apply treat-to-target and TC strategies.
“The rigorous frequent monitoring visits in a tight control treatment strategy does not impact QoL [and] the addition of prednisone to such a strategy does not impact QoL.”
Disclosure: The researchers report no relevant financial disclosures.
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