Abstract
BACKGROUND: Rheumatoid arthritis (RA) is a chronic, progressive autoimmune disorder characterized by joint pain, stiffness, and deformities, leading to functional impairment and reduced quality of life (QoL). Disease-modifying anti-rheumatic drugs (DMARDs) are the cornerstone of therapy, effectively reducing disease activity and improving health-related QoL (HRQoL). OBJECTIVE: To compare HRQoL outcomes between seropositive and seronegative RA patients and to assess the improvement in HRQoL following initiation of conventional synthetic DMARDs (csDMARDs) in both seropositive and seronegative RA patients. METHODOLOGY: This prospective, comparative, non-randomized experimental study was conducted over 16 months and included 104 patients with RA who met the inclusion criteria - 87 seropositive and 17 seronegative. All participants received csDMARD therapy and were evaluated using the visual analogue scale (VAS) for pain, Disease Activity Score 28 (DAS28 ESR) for disease severity, and the SF-36 questionnaire for HRQoL at baseline, three months, and six months. RESULTS: Both seropositive and seronegative groups showed significant improvement in HRQoL after csDMARD initiation as measured by the SF-36 index. No significant intergroup differences were observed in HRQoL outcomes. However, the seronegative group demonstrated a more pronounced reduction in pain and disease severity, as indicated by VAS and DAS28-ESR scores, compared to the seropositive group. CONCLUSION: Early initiation of csDMARDs in RA patients leads to significant improvement in QoL, regardless of serostatus. While both groups benefited similarly in HRQoL, seronegative patients experienced greater reductions in pain and disease activity, underscoring the efficacy of csDMARDs as an initial treatment strategy in RA management.