Patients with rheumatoid arthritis (RA) who’s disease is controlled on multiple levels—according to clinical markers, ability to function, and structural improvement—may experience better quality of life. These findings were published in the Annals of Rheumatic Disease.
Researchers with this recent study in England evaluated how patients faired overall when RA symptoms were controlled on a range of levels. The degree of control, which they called comprehensive disease control (CDC), took into account clinical (or medically determined) measures of RA, the patients’ ability to function, and the structure of joints affected by RA.
The evaluate the effect of CDC on patient quality of life and other outcomes, the researchers used data from three treatment trials of early- and late-stage RA. These trials evaluated HUMIRA® (adalimumab) plus Trexall® (methotrexate), a treatment combination shown to reduce symptoms of RA and slow the progression of joint damage.
To define CDC the researchers used the following established measurements of RA disease activity: the 28-joint Disease Activity Score (an examination of 28 specific joints), Health Assessment Questionnaire (a self-reported functional status measure), and Total Sharp Score (a scoring system for damage as seen on X-ray). Patients who experienced CDC at 26 weeks of treatment were evaluated for work-related outcomes, physical and mental status, pain, fatigue, and ability to function.
Patients who experienced CDC at 26 weeks faired significantly better overall than those without CDC at 26 weeks. They had less pain, less fatigue, and improved mental and physical status. When patients were assessed again 52 weeks, they appeared to maintain these improvements.
It appears that CDC in patients with RA can contribute to better overall quality of life, both short and long term. These findings underscore the importance of choosing treatment approaches that improve symptoms and control disease on multiple levels.
 Emery P, Kavanaugh A, Bao Y, et al. Comprehensive Disease Control (CDC): What Does Achieving CDC Mean for Patients with Rheumatoid Arthritis? Ann Rheum Dis doi:10.1136/annrheumdis-2014-205302.
 Keystone EC, van der Heijde D, Kavanaugh A, et al. Clinical, Functional, and Radiographic Benefits of Longterm Adalimumab plus Methotrexate: Final 10-Year Data in Longstanding Rheumatoid Arthritis. J Rheumatol. 2013 Sep;40(9):1487-97. doi: 10.3899/jrheum.120964.