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    Health-related quality of life in early rheumatoid arthritis: impact of disease and treatment response

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    Authors
    Kosinski, Mark
    Kujawski, Sara C.
    Martin, Richard
    Wanke, Lee A.
    Buatti, Mary C.
    Ware, John E. Jr.
    Perfetto, Eleanor M.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2002-03-28
    Keywords
    Adult
    Aged
    Antirheumatic Agents
    Arthritis, Rheumatoid
    *Cost of Illness
    Female
    Humans
    Immunoglobulin G
    Male
    Methotrexate
    Middle Aged
    Pain Measurement
    Questionnaires
    Receptors, Tumor Necrosis Factor
    *Sickness Impact Profile
    Treatment Outcome
    United States
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://www.ajmc.com/media/pdf/AJMC2002marKOSINSKIp231.pdf
    Abstract
    OBJECTIVE: To document the burden of early rheumatoid arthritis (RA) on health-related quality of life (HQL) and compare changes in HQL across 2 treatments. STUDY DESIGN: Analysis of HQL scores among patients enrolled in a multicenter, double-blind, randomized control trial of early RA treatment. PATIENTS AND METHODS: A total of 424 patients with early RA were randomized to 1 of 2 treatment groups: etanercept or methotrexate. Patients were treated and followed for 52 weeks. Health-related quality of life was assessed before and throughout treatment using the Medical Outcomes Study Short Form 36 Health Survey (SF-36) and the Health Assessment Questionnaire (HAQ). The HQL burden of RA was established by comparing SF-36 scale scores to general US population norms. The impact of treatment on HQL was determined by comparing scores on both SF-36 and HAQ scales. RESULTS: Before treatment, RA patients showed significant decrements in scores on all SF-36 scales and summary measures in comparison with age- and sex-matched general US population norms, multivariate analysis of variance (MANOVA) F(8,2815) = 204.6, P < .0001. After 52 weeks of treatment, 7 of 8 SF-36 scales and the physical summary measure remained significantly below the general US population norm, MANOVA F(8,2815) = 41.9, P < .0001. Patients randomized to etanercept showed significantly better HQL improvement earlier in treatment than patients randomized to methotrexate on the SF-36 physical summary, MANOVA F(10,4230) = 6.1, P< .0001, the SF-36 arthritis-specific health index, MANOVA F(10,4230) = 8.5, P < .0001, and the HAQ, MANOVA F(10,4230) = 14.7, P < .0001. At 52 weeks, there were no significant differences between treatment groups. CONCLUSIONS: Rheumatoid arthritis places tremendous disease burden on patients' HQL. Successful treatment of early RA improved HQL. Etanercept showed a rapid HQL response.
    Source
    Am J Manag Care. 2002 Mar;8(3):231-40. Link to article on publisher's site
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47445
    PubMed ID
    11915973
    Related Resources
    Link to Article in PubMed
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    Population and Quantitative Health Sciences Publications

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