Hacettepe Üniversitesi Romatoloji Kliniğinde Biyolojik Dmard Tedavisi Başlanan Romatoid Artrit Hastalarında Takip Süresi On Yılın Üzerinde Olanların Klinik ve Demografik Özelliklerinin Değerlendirilmesi
Göster/ Aç
Tarih
2023Yazar
Güven Şahan, Özlem
Ambargo Süresi
Acik erisimÜst veri
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This study aims to
examine the clinical and demographic characteristics of patients with Rheumatoid
Arthritis (RA) who have the potential to receive biological drug treatment for over ten
years and to identify factors associated with adherence to treatment during follow-up
for more than ten years. The study included 640 RA patients who were followed
between 2001 and 2022 at Hacettepe University, Department of Rheumatology.
Retrospectively collected data were analyzed using appropriate statistical methods. Of
all patients, 242 (37.8%) had a follow-up duration of over ten years, while 398 (66.7%)
had less than ten years. Among the patients with a follow-up duration of over ten years,
197 were female (81.4%), and 218 (90.9%) were under bDMARD therapy at their last
visit. 131 patients (54.1%) were admitted from Ankara, the capital city of Turkey.
While 50.2% of the patients from Ankara had been followed for over ten years, only
29.8% of those from outside Ankara had been followed for the same duration
(p<0.001). The average age of onset of symptoms for patients with a follow-up
duration of over ten years was 36.9 ± 12.9 years, the average age at diagnosis was 38.7
± 12.9 years, and the average duration between the onset of symptoms and the start of
bDMARD treatment was 8.8 ± 6.9 years. Compared to patients with less than ten years
of follow-up, patients with long-term follow-up had a longer time between the first
symptom and initiation of bDMARD. Patients with treatment adherence had a higher
prevalence of strong positive rheumatoid factor, higher frequency of being overweight,
and a higher prevalence of metabolic syndrome components such as hypertension,
diabetes, and hyperlipidemia. Treatment adherence was higher in patients with wellcontrolled
acute phase response during long-term follow-up. Using synthetic
DMARDs alongside bDMARDs did not significantly affect treatment adherence for
over ten years. Long-term adherence was achieved when intravenous (i.v) treatment
was used as the initial treatment option. While the patients' initial and follow-up
activity values did not affect treatment continuity, patients with worse functional status
were followed for a longer duration. At least 37.8% of the patients receiving bDMARD
treatment have continued their follow-up at our center, while 34% continue to receive
any bDMARD treatment. In conclusion, factors such as proximity of patients' place of
residence to the hospital where they receive treatment, duration between the onset of
symptoms and the start of bDMARD treatment, and pre-biological agent initiation
CRP value appear to be important in terms of continued treatment follow-up for over
ten years.