In this study, we compare the health-related quality of life (HRQoL) of patients with moderate-to-severe
rheumatoid arthritis (RA),
psoriatic arthritis (PsA), and
ankylosing spondylitis (AS), and study the effect of treatment with
infliximab on the HRQoL of patients with these diseases. Short Form Health Survey-36 (SF-36) data from the placebo-controlled phases of 4 studies of
infliximab in patients with inflammatory
rheumatic diseases (n = 1990) were evaluated. Data came from the Anti-TNF Trial in
Rheumatoid Arthritis with Concomitant
Therapy (ATTRACT) (n = 428), the Safety Trial for
Rheumatoid Arthritis with
REMICADE Therapy (START) (n = 1083), the
Ankylosing Spondylitis Study for the Evaluation of Recombinant
Infliximab Therapy (ASSERT) (n = 279), and the
Infliximab Multinational
Psoriatic Arthritis Clinical Trial II (IMPACT II) (n = 200). SF-36 assessments were made at weeks 0, 10, 30, and 54 in ATTRACT, weeks 0, 6, and 22 in START, weeks 0, 12, and 24 in ASSERT, and weeks 0 and 14 in IMPACT II. All patient populations had significantly impaired physical aspects of HRQoL at baseline relative to the general population of the United States, and the magnitude of impairment was similar across the diseases. Mean baseline physical component summary scores were 29 in the RA cohort, 32 in the PsA cohort, and 29 in the AS cohort. In all 3 diseases, patients who received
infliximab showed significant improvement in physical component summary scores compared with those who received placebo. The magnitude of the difference of improvement (effect size, 95%CI) between
infliximab and placebo groups was similar in the AS (10.1, 9.2-11.0), PsA (8.6, 7.8-9.4), and RA (10.1, 9.2-11.0) cohorts. Patients with RA and those with PsA treated with
infliximab also showed greater improvement in the mental component summary score than those in the placebo group with an effect size of 4.6 (4.2-5.1) in RA and 2.7 (2.4-3.1) in PsA. Patients in large randomized controlled studies of
infliximab in RA, PsA, and AS had similar impairment in physical aspects of HRQoL at baseline and showed significantly greater improvement in HRQoL
after treatment with
infliximab.