1211 - Impact of Rituximab On the Quality of Life and Physical Function of Patients with Rheumatoid Arthritis: Results From the British Society for Rheumatology Biologics Register

Monday, November 7, 2011: 9:00 AM-6:00 PM
Hall F2 - Poster Hall (McCormick Place West)
Moetaza M. Soliman1, Kimme L. Hyrich2, Mark Lunt2, Kath D. Watson2, Deborah PM Symmons2 and Darren M. Ashcroft1, 1School of Pharmacy and Pharmaceutical sciences, University of Manchester, Manchester, United Kingdom, 2Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester, United Kingdom
Presentation Number: 1211


Improvements in the quality of life and physical function of rheumatoid arthritis (RA) patients receiving rituximab (RTX) have been shown in clinical trials. This study aimed to assess quality of life and physical function of RA patients six months after receiving RTX in routine clinical practice in the UK, and to identify factors that were associated with improvements in physical function.


The study included 448 RA patients registered with the British Society for Rheumatology Biologics Register, a national prospective cohort study, who were starting RTX and provided Health Assessment Questionnaire (HAQ) at baseline and six months after starting RTX. Changes in the HAQ scores and European Quality of life 5 Dimensions (EQ5D) ratings were used to evaluate improvements in physical function and quality of life. Multivariate regression models were used to identify factors that were associated with improvements in HAQ scores in patients receiving RTX who had failed at least one anti-tumour necrosis factor therapy. The models examined baseline demographic and disease characteristics, baseline physical function, concomitant drug therapies and previous biologic and non-biologic therapies.


Six months after starting RTX, the mean HAQ, EQ5D utility, and EQ5D visual analogue scores had significantly improved (table 1). Over one third of patients (36%) achieved the minimal clinically important difference (MCID) in HAQ (improvement of 0.22 units at least). The multivariate analysis found that high baseline HAQ score was significantly associated with an improvement in HAQ (table 2). Patients receiving concurrent steroids were significantly less likely to show an improvement in HAQ. Older patients, females, and current smokers were also significantly less likely to show either HAQ improvements or achieving MCID in HAQ.


In routine clinical practice, RTX was found to be effective in improving the quality of life and physical function of RA patients. Factors that influenced the degree of improvement in physical function included: baseline disability, smoking, concurrent use of steroids, age, and gender.

Table 1: Six months improvements



Six months

Mean HAQ (95% CI) *

1.96 (1.91, 2.02)

1.84 (1.78 to 1.90)

Mean EQ VAS (95% CI) †

45.6 (43.5, 47.7)

53.0 (51.1 to 54.9)

Mean EQ5D utility score (95% CI) §

0.29 (0.26, 0.32)

0.39 (0.36 to 0.42)

*HAQ range is 0 to 3, EQ VAS range is 0 to 100, § utility score range is -0.59 to 1.00

Table 2: Significant predictors of HAQ improvements

Baseline factor

Linear Change in HAQ

(Coefficient (95% CI))

Achieving MCID in HAQ

(Odds ratio (95% CI))

Age (10 years)

0.07 (0.03 to 0.11)*

0.72 (0.55 to 0.93)*


0.14 (0.04 to 0.25)*

0.47 (0.25 to 0.91) *

Baseline HAQ

-0.13 (-0.20 to -0.06)*

1.49 (0.92 to 2.41)

Concurrent steroids

0.09 (0.01 to 0.18)*

0.63 (0.37 to 1.07)

Current smoking

0.13 (0.02 to 0.24)*

0.45 (0.21 to 0.96)*

*P < 0.05

Keywords: Health Assessment Questionnaire, rheumatoid arthritis (RA) and rituximab

Disclosure: M. M. Soliman, None; K. L. Hyrich, None; M. Lunt, None; K. D. Watson, None; D. P. Symmons, None; D. M. Ashcroft, None.