ABSTRACT

Objectives: This study aims to evaluate and compare the use of subcutaneous anti-TNF for RA in a Brazilian real-life setting.

Methods: A prospective cohort of biological disease-modifying antirheumatic drug (bDMARD)-naïve patients treated with adalimumab, etanercept, golimumab, and certolizumab was developed. Medication persistence, disease activity by the Clinical Disease Activity Index (CDAI), functionality by the Health Assessment Questionnaire (HAQ), quality of life by the European Quality of Life 5 Dimensions (EQ-5D), and safety were evaluated at 6 and 12 months.

Results: In a total of 327 individuals, 211 (64.5%) were persistent at 12 months. Patients improved after the use of anti-TNF, with a reduction in the mean of CDAI and HAQ, in addition to an increase in the mean of EQ-5D (p < 0.05). The number of patients who achieved the clinical response was 114 (34.86%) by CDAI, 212 (64.83%) by HAQ, and 215 (65.75%) by EQ-5D at 12 months. There were no statistically significant differences among the drugs (p > 0.05). The anti-TNF was well tolerated.

Conclusion: Anti-TNF reduced disease activity, in addition to improving patients’ functionality and quality of life. Additional pharmacotherapeutic monitoring can be essential to achieve better results.

摘要

目的：本研究旨在评估和比较在巴西现实生活环境中皮下抗 TNF 治疗 RA 的应用。

方法：开发了一个前瞻性队列，其中包括使用阿达木单抗、依那西普、戈利木单抗和赛妥珠单抗治疗的生物疾病缓解性抗风湿药 (bDMARD) 初治患者。药物持续性、临床疾病活动指数 (CDAI) 的疾病活动度、健康评估问卷 (HAQ) 的功能性、欧洲生活质量 5 维度 (EQ-5D) 的生活质量和安全性在 6 和 12 进行评估个月。

结果：在总共 327 名个体中，211 名 (64.5%) 在 12 个月时持续存在。使用抗 TNF 后患者病情有所改善，CDAI 和 HAQ 的平均值降低，EQ-5D 的平均值增加（p < 0.05）。在 12 个月时，CDAI 达到临床反应的患者数为 114（34.86%），HAQ 为 212（64.83%），EQ-5D 为 215（65.75%）。药物间差异无统计学意义（p >0.05）。抗TNF耐受性良好。

结论：抗 TNF 可降低疾病活动度，同时改善患者的功能和生活质量。额外的药物治疗监测对于获得更好的结果至关重要。