The impact of rheumatoid arthritis and treatment on patients' lives

Rheumatoid arthritis (RA) is a chronic, debilitating disease that significantly impacts patients' quality of life and socioeconomic productivity. On a personal level, RA has a significant socioeconomic impact on patients' lives, being ranked among the highest of all chronic diseases for its effect on health-related quality of life (HRQoL), and limitations in physical function as well as increased pain and fatigue affect patients' attendance at paid work, their work performance within and outside the home, and their participation in family, social, and leisure activities. Additional paid or unpaid support, as well as increased flexibility and job modifications from employers, are often required so that patients can meet their role obligations. Disease-related reductions in work and household productivity are not just due to the physical limitations posed by RA; mental/emotional limitations also play a key role in reducing patients' HRQoL and productivity. Newer, effective treatments, such as tumor necrosis factor (TNF) inhibitors, improve the signs and symptoms of disease, inhibit progression of joint damage, and improve physical function and HRQoL. A recently available TNF inhibitor for RA, certolizumab pegol, has been shown to increase productivity outside and within the home and participation in family, social, and leisure activities as well as rapidly improve physical function, fatigue, and pain. Due to the importance of these parameters to patients, new therapies are increasingly assessed based on their ability to improve HRQoL, productivity, and participation. These extend the more traditional measures of efficacy into outcomes that are more central to patients' daily lives.