Comprehensive disease control in rheumatoid arthritis is associated with meaningful benefits such as short- and long-term improvements in quality of life, pain, fatigue, and work attendance, a meta-analysis has found.
Using pooled data from three randomized controlled trials of adalimumab plus methotrexate in 1,467 patients with early- or late-stage rheumatoid arthritis, researchers found mean improvements of 20 points in pain scores from baseline, 5.8 points in fatigue scores, 10.8 points in physical quality of life scores, and 3.1 points in mental quality of life scores, among patients who achieved comprehensive disease control at 26 weeks – all of which were significantly greater than those of patients who did not achieve CDC.
Dr. Paul Emery
Compared with patients achieving Disease Activity Score remission alone, "CDC achievement was associated with statistically significant and clinically meaningful differences of 7.0 (4.0-10.0) and 6.9 (3.5-10.4) in SF-36 PCS [Short Form-36 physical component scores] at weeks 26 and 52, respectively," wrote Dr. Paul Emery and his colleagues. Dr. Emery is director of the Leeds (England) Institute of Rheumatic & Musculoskeletal Medicine, and director of the Leeds Musculoskeletal Biomedical Research Unit.
The researchers defined CDC as achievement of a 28-joint Disease Activity Score using C-reactive protein of less than 2.6, a Health Assessment Questionnaire score below 0.5, and change from baseline in modified total Sharp score of 0.5 or less, according to the paper, which was published online Aug. 19 in Annals of the Rheumatic Diseases (doi: 10.1136/annrheumdis-2014-205302).
The study was funded by AbbVie. Three authors are AbbVie employees, and the other authors reported grant support and consultancies for a range of pharmaceutical companies.