Self-reported outcomes during treatment with tumour necrosis factor [agr] inhibitors in patients with rheumatoid arthritis

The objective of this study was to study how patients with rheumatoid arthritis (RA) self-report their experience of disease-related symptoms (fatigue, morning stiffness, pain) and their ability to cope with everyday life (capacity) using a nurse-led structured follow-up during the first year after starting treatment with tumour necrosis factor [agr] (TNF-[agr]) inhibitors. Thirty-nine patients, who were being treated for their RA in our outpatient rheumatology clinic and were beginning treatment with TNF-[agr] inhibitors, agreed to evaluate and self-report their experience of fatigue, morning stiffness, pain, and capacity using the visual analogue scale (VAS) every third month during their first year of treatment. A quantitative method was used to study the changes in these four variables. In addition, at the same time, we studied the relationship between self-reported capacity and each of the three symptoms. After 12 months’ treatment with TNF-[agr] inhibitors all changes were statistically significant. Baseline and 12 months’ capacity correlated significantly with fatigue, morning stiffness and pain In addition, the median change in self-reported capacity correlated significantly with the median change in each of the three symptoms.

During the first year of treatment with TNF-[agr] inhibitors, patients reported decreased fatigue, morning stiffness and pain, while their capacity increased. The increased capacity rate closely followed the decrease in symptom rate.

Sidona-Valentina Bala, Kristina Forslind, Marie Edwinson Månsson. Self-reported outcomes during treatment with tumour necrosis factor [agr] inhibitors in patients with rheumatoid arthritis. Musculoskeletal Care, 6 Nov 2009, online article ahead of print