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    Health-related quality of life and continuation rate on first-line anti-tumour necrosis factor therapy among rheumatoid arthritis patients from the Australian Rheumatology Association Database

    Access Status
    Open access via publisher
    Authors
    Staples, M.
    March, L.
    Lassere, M.
    Reid, Christopher
    Buchbinder, R.
    Date
    2011
    Type
    Journal Article
    
    Metadata
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    Citation
    Staples, M. and March, L. and Lassere, M. and Reid, C. and Buchbinder, R. 2011. Health-related quality of life and continuation rate on first-line anti-tumour necrosis factor therapy among rheumatoid arthritis patients from the Australian Rheumatology Association Database. Rheumatology. 50 (1): pp. 166-175.
    Source Title
    Rheumatology
    DOI
    10.1093/rheumatology/keq322
    ISSN
    1462-0324
    School
    Department of Health Policy and Management
    URI
    http://hdl.handle.net/20.500.11937/20361
    Collection
    • Curtin Research Publications
    Abstract

    Objectives: To describe changes in health-related quality of life (HRQoL) up to 60 months after commencing anti-TNF therapy for RA patients enrolled in the Australian Rheumatology Association Database (ARAD), and to determine the continuation rate and predictors of discontinuation of first-line anti-TNF therapy. Methods: Responses to the HAQ, Assessment of Quality of Life, Medical Outcomes Study Short Form-36 (SF-36) and European Quality of Life-5 Dimensions (EQ-5D) were extracted from ARAD for patients commencing anti-TNF therapy and analysed in 6-monthly intervals from the start date. Predictors of discontinuation of therapy were assessed using Cox regression. Results: Since September 2001, 2601 RA patients have enrolled in ARAD; 1801 have used anti-TNF therapy. Before starting the therapy, all HRQoL scores were below the population norms, but showed improvements in the first 6 months. From 12 to 60 months, HRQoL remained stable but below population means. Data to 60 months were available for 106 patients; 47% were still on first-line therapy at 5 years, all were using concurrent DMARDs and 55% were using concurrent prednisolone. Predictors of discontinuation of therapy were poorer HRQoL scores, a more recent therapy start date, concurrent prednisolone use and self-reported severe infection. Older patients and those with longer symptom duration were more likely to remain on therapy. Conclusions: In routine practice, HRQoL scores improve rapidly within 6 months of starting anti-TNFs and then remain stable for up to 60 months. Almost half remain on first-line therapy. © The Author 2010. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.

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