FRI0115 TRAJECTORIES OF THE EQ-5D SCORE AMONG A LARGE COHORT OF RHEUMATOID ARTHRITIS PATIENTS TREATED WITH BIOLOGICAL DMARDS USING THE IORRA COHORT
Authors: Kumiko Saka, Eiichi Tanaka, Eisuke Inoue, Mai Abe, Mika Kawano, Eri Sugano, Naohiro Sugitani, Moeko Ochiai, Yoko Shimizu, Rei Yamaguchi, Naoki Sugimoto, Katsunori Ikari, Ayako Nakajima, Atsuo Taniguchi, Hisashi Yamanaka
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Patient-reported outcomes are important for evaluating the disease status of patients with rheumatoid arthritis (RA). The EuroQol five-dimensional descriptive system (EQ-5D) has been used to assess health-related quality of life (QOL) in clinical research and pharmacoeconomic studies. RA is a chronic disease associated with pain, fatigue, disability, and functional loss, which can markedly decrease patient QOL. The treatment strategies for RA and the QOL of RA patients, which is evaluated in daily practice using the EQ-5D, have changed significantly since the introduction of biological disease-modifying anti-rheumatic drugs (bDMARDs). <h3>Objectives:</h3> To identify patient subsets with distinct EQ-5D trajectories among RA patients taking bDMARDs, and to examine the clinical features of patients whose QOL improved since bDMARD use in daily practice. <h3>Methods:</h3> Since October 2000, we have established a large observational cohort of RA patients at our institute Institute Of Rheumatology, Rheumatoid Arthritis (IORRA). Essentially, all RA patients who attend our clinic are given questionnaires, including the EQ-5D, Disease Activity Score 28 (DAS28), and the Japanese version of the Health Assessment Questionnaire (J-HAQ), every 6 months. More than 5,000 RA patients are included in this cohort, of whom 785 patients who received bDMARDs for at least 3 years were enrolled in this study. The EQ-5D scores of these 785 patients were recorded biannually for 3 years, and latent class analysis of the temporal trends in the EQ-5D score based on posterior probabilities was performed after initiation of bDMARDs. The clinical characteristics of each latent class were then compared. <h3>Results:</h3> The 785 patients (107 taking infliximab, 341 etanercept, 100 tocilizumab, 131 abatacept, 90 golimumab, and 16 certolizumab pegol) were classified into four classes based on time-related changes in their EQ-5D scores: Class 1 (n = 160), patients with a consistently low score &lt; 0.6 despite use of bDMARDs; Class 2 (n = 314), patients with a consistently moderate score of ∼0.7); Class 3 (n = 229), patients whose score improved from ∼0.7 to 0.9 after use of bDMARDs; and Class 4 (n = 82), patients with a consistently high score of ∼0.9. When comparing the patients in Classes 2 and 3, whose EQ-5D scores before bDMARD use were similar, the patients in Class 3 had a younger age (<i>p</i>&lt;0.001), shorter disease duration (<i>p</i>&lt;0.001), higher DAS28 score (<i>p</i>&lt;0.001), lower J-HAQ score (<i>p</i>=0.038), and more frequent use of non-steroidal agents (<i>p</i>=0.002) than those of Class 2 patients. <h3>Conclusion:</h3> The results of this study suggest that QOL is less likely to improve in patients with RA whose disabilities and QOL deterioration have already become established despite use of bDMARDs. We also determined the clinical features of RA patients whose QOL improved after initiation of bDMARDs. <h3>Disclosure of Interests:</h3> Kumiko Saka: None declared, Eiichi Tanaka Speakers bureau: Abbvie, Asahi Kasei pharma co., Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo Co., Eisai Pharmaceutical, Janssen Pharmaceutical K.K., Nippon Kayaku, Pfizer, Takeda Pharmaceutical, Taisho Toyama Pharmaceutical Co., and UCB Pharma., Eisuke Inoue: None declared, Mai Abe: None declared, Mika Kawano: None declared, Eri Sugano: None declared, Naohiro Sugitani: None declared, Moeko Ochiai: None declared, Yoko Shimizu: None declared, Rei Yamaguchi: None declared, Naoki Sugimoto: None declared, Katsunori Ikari: None declared, Ayako Nakajima Grant/research support from: Asahi Kasei pharma co., Chugai Pharmaceutical, Daiichi Sankyo Co., Pfizer, Kissei Pharmaceutical Co., and Mitsubishi Tanabe Pharma Corporation., Atsuo Taniguchi: None declared, Hisashi Yamanaka Grant/research support from: AbbVie, Eisai, Bristol-Meyers, Novartis, Behringer, Astellas, Kaken, Nippon-Shinyaku, Pfizer, UCB, Ayumi, Ono, Daiichi-Sankyo, Taisyo-Toyama, Takeda, Tanabe-Mitsubishi, Chugai, Teijin Pharma, Torii, YLbio, Speakers bureau: Bristol-Meyers, Astellas, Pfizer, Daiichi-Sankyo, Takeda, Tanabe-Mitsubishi, Chugai, Teijin Pharma, YLbio