Impact of Biological Therapy on Fatigue, Functional Status, and Health-Related Quality of Life in Rheumatoid Arthritis Patients: Results from Real-Life Practice.

Background: Rheumatoid arthritis (RA) is an autoimmune inflammatory condition that adversely affects health-related quality of life (HRQoL) by causing joint damage, pain, functional impairment, and fatigue.

Objectives: The aim of this study was to assess the impact of biological disease-modifying antirheumatic drugs (bDMARDs) on fatigue, functional disability, and HRQoL in an Egyptian cohort with RA.

Methods: This observational analytical prospective cohort study included RA patients who needed to start bDMARDs immediately after the enrolment visit at two Rheumatology and Immunology Units. Clinical, therapeutic, and laboratory data were assessed at baseline and 4 months after administration of bDMARDs, along with the Functional Assessment of Chronic Illness Therapy-Fatigue 13 items, Health Assessment Questionnaire Disability Index (HAQ-DI), and Short Form-12 Health Survey (SF-12) questionnaires.

Results: A total of 85 patients with RA were included (mean age: 41.7 years). Most of the participants were female (87.1%). The most commonly administered bDMARDs were adalimumab (n = 26), golimumab (24), and etanercept (15). After bDMARD administration, there was significant improvement in the severity of fatigue (P <0.001, 95% CI: 14.59, 20.29) and median HAQ-DI scores (from 1.68 to 0.68; P <0.001, 95% CI: -1.06, -0.92). The number of patients with severe to very severe disability decreased significantly from 29 at baseline to 4 after 4 months after administration of bDMARDs (P <0.001). Additionally, the SF-12 domains showed significantly better scores after 4 months compared with baseline.

Conclusions: Administration of bDMARDs is associated with significant improvement in fatigue, functional disability, and health-related quality of life in patients with rheumatoid arthritis.