Early improvement of health-related quality of life during treatment with etanercept and adalimumab in patients with rheumatoid arthritis in routine practice.

OBJECTIVES To assess health-related quality of life (HRQoL) in patients with rheumatoid arthritis (RA) treated with etanercept or adalimumab in routine clinical practice. METHODS Patients with RA who started etanercept or adalimumab at Helsinki University Central Hospital or Lappeenranta Central Hospital during 2003-2006 were asked to participate in the study. In 97 patients, HRQoL was measured by the RAND 36-Item Health Survey 1.0 (RAND-36) at baseline and after three months of the treatment. HRQoL of the RA patients was compared to the Finnish age- and sex-matched general population values. In addition, changes in clinical parameters and disability index measured by the health assessment questionnaire (HAQ) were recorded. RESULTS Treatment with etanercept and adalimumab increased the values in all domains of the RAND-36 during the first three months in routine practice. The improvement in both groups was statistically significant: with etanercept p=0.041 and with adalimumab p=0.019. The efficacy of etanercept and adalimumab in improving HRQoL during the first three months was comparable. The patients reported their best improvement in the subscales of bodily pain, role functioning/physical, energy, social functioning, and role functioning/emotional. Compared to the Finnish age- and sex-matched general population values, the HRQoL of the patients with RA was significantly lower at baseline and remained low at follow-up. The change in clinical parameters and the HAQ paralleled the improvement in HRQoL. CONCLUSION Treatment of patients with RA with etanercept and adalimumab in routine clinical practice provides clinically important and statistically significant improvement in HRQoL already in the first three months.