Impact of biological/targeted versus conventional synthetic disease‐modifying antirheumatic drugs on patient‐reported outcomes in rheumatoid arthritis

Abstract Background In patients with rheumatoid arthritis (RA), patient‐reported outcomes (PROs) may vary by disease‐modifying antirheumatic drug (DMARD) class. This study aimed to assess the impact of biological/targeted synthetic DMARDs (b/tsDMARDs) on PROs in patients with sustained low RA activity or remission, compared with those treated with conventional synthetic DMARDs (csDMARDs) alone. Methods A retrospective cross‐sectional study was conducted on patients who maintained low RA activity or remission for at least 6 months. PROs, including the Short Form‐36, Health Assessment Questionnaire, EuroQol 5 Dimensions, Routine Assessment of Patient Index Data 3, and Functional Assessment of Chronic Illness Therapy–Fatigue scale, were assessed and compared between patients treated with csDMARDs alone and those treated with b/tsDMARDs with or without methotrexate (MTX). Results This study enrolled 102 patients with RA, and found that patients treated with antitumor necrosis factor‐alpha inhibitors had better PROs compared with those treated with csDMARDs alone, particularly in role physical (coefficient: 5.37, 95% confidence interval [CI]: 0.35–10.39), role emotional (coefficient: 5.78, 95% CI: 1.04–10.52), vitality (coefficient: 5.23, 95% CI: 0.57–9.90) and mental health (coefficient: 5.58, 95% CI: 1.37–9.79). Similarly, treatment with interleukin‐6 receptor inhibitors and Janus kinase inhibitors resulted in superior PROs in role physical (coefficient: 5.76 [95% CI: 0.06–11.48] and 8.99 [95% CI: 1.97–16.01], respectively) compared with csDMARDs. Furthermore, MTX use was associated with improvements in vitality (coefficient: 4.34, 95% CI: 0.14–8.54) and mental health (coefficient: 4.59, 95% CI: 0.82–8.35). Conclusion b/tsDMARDs, particularly tumor necrosis factor‐alpha inhibitors, provide superior PROs in patients with sustained RA low activity or remission, with additional benefits from MTX.