Comparison of health-related quality of life in rheumatoid arthritis, psoriatic arthritis and psoriasis and effects of etanercept treatment

Abstract

Objectives: To compare health-related quality of life (HRQoL) before and after treatment with etanercept in patients with moderate to severe rheumatoid arthritis (RA), psoriatic arthritis (PsA) and psoriasis using spydergram representations.

Methods: Data from randomised, controlled trials of etanercept in patients with RA, PsA and psoriasis were analysed. HRQoL was assessed by the medical outcomes survey short form 36 (SF-36) physical (PCS) and mental (MCS) component summary and domain scores. Baseline comparisons with age and gender-matched norms and treatment-associated changes in domain scores were quantified using spydergrams and the health utility SF-6D measure.

Results: Mean baseline PCS scores were lower than age and gender-matched norms in patients with RA and PsA, but near normative values in patients with psoriasis; MCS scores at baseline were near normal in PsA and psoriasis but low in RA. Treatment with etanercept resulted in improvements in PCS and MCS scores as well as individual SF-36 domains across all indications. Mean baseline SF-6D scores were higher in psoriasis than in RA or PsA; clinically meaningful improvements in SF-6D were observed in all three patient populations following treatment with etanercept.

Conclusions: Patients with RA, PsA and psoriasis demonstrated unique HRQoL profiles at baseline. Treatment with etanercept was associated with improvements in PCS and MCS scores as well as individual domain scores in patients with RA, PsA and psoriasis.

Figure 1

Short form 36 (SF-36) spydergrams for patients with rheumatoid arthritis. Mean SF-36 scores at baseline and week 52 and age and gender-matched norms are shown for patients receiving (A) methotrexate or (B) etanercept plus methotrexate. (C) Mean SF-36 scores at baseline and week 52 for patients treated with methotrexate or etanercept plus methotrexate are compared. Mean SF-36 scores for age and gender-matched norms are also shown. BP, bodily pain; ETN, etanercept; GH, general health; MH, mental health; MTX, methotrexate; PF, physical function; RE, role emotional; RP, role physical; SF, social functioning; VT, vitality.

Figure 2

Short form 36 (SF-36) spydergrams for patients with psoriatic arthritis. Mean SF-36 scores at baseline and weeks 4, 12 and 24, and age and gender-matched norms are shown for patients receiving (A) placebo or (B) etanercept. (C) Mean SF-36 scores at baseline and week 24 for patients treated with placebo or etanercept are compared. Mean SF-36 scores for age and gender-matched norms are also shown. BP, bodily pain; ETN, etanercept; GH, general health; MH, mental health; PF, physical function; PL, placebo; RE, role emotional; RP, role physical; SF, social functioning; VT, vitality.

Figure 3

Short form 36 (SF-36) spydergrams for patients with psoriasis. Mean SF-36 scores at baseline and week 12 of the randomised controlled trial (RCT) portion of the clinical trial and age and gender-matched norms are shown for patients receiving (A) placebo, (B) etanercept 25 mg twice a week (BIW), or (C) etanercept 50 mg twice a week. Mean SF-36 scores at baseline and weeks 12 and 24 of the open-label (OL) portion of the trial (when all patients received etanercept 25 mg twice a week) are shown for patients who had received (D) placebo, (E) etanercept 25 mg twice a week, or (F) etanercept 50 mg twice a week during the RCT portion of the trial. Mean SF-36 scores for age and gender-matched norms are also shown.

Figure 4

Comparison of health-related quality of life (HRQoL) across indications. (A) Mean short form 36 (SF-36) scores for patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), or psoriasis (PsO) at baseline and average age and gender-matched norms for all indications are shown. (B) Mean SF-36 values at endpoint are shown for patients with RA (etanercept (ETN) plus methotrexate (MTX)-treated patients at week 52), PsA (etanercept-treated patients at week 24), and psoriasis (etanercept 50 mg twice a week (BIW)-treated patients at week 12) with average age and gender-matched norms for all indications. (C) Mean SF-36 scores at baseline for age and gender-matched norms are shown.