ABSTRACT
OBJECTIVE: To investigate the effects of both the Fc fragment in tumor necrosis factor (TNF) inhibitors and rheumatoid factor (RF) titers on treatment survival, disease activity, and laboratory parameters in patients with rheumatoid arthritis (RA). METHODS: In this retrospective cohort study, patients with RA who had started any anti-TNF therapy between January 2017 and March 2020 and who had stayed on this treatment for at least six months were included. The data of the patients were compared separately according to continuation or discontinuation of treatment and the presence or absence of Fc portion in the structure of anti-TNFs. Patients who were taking certolizumab pegol (CZP) without the Fc fragment were placed in the "without Fc group" (wo/Fc), while patients who were taking other drugs (adalimumab, etanercept, golimumab, and infliximab) were placed in the "with Fc group" (w/Fc). RESULTS: Among the 221 RA patients whose data were available, 52 patients met the inclusion criteria and were included in the study. There was a significant difference in the DAS28-CRP score between wo/Fc group and w/Fc group in the third month of treatment (p=0.012). However, this difference did not persist at the sixth month of treatment (p=0.384). According to the cox-regression results, RF titers were determined to have a significant impact on the drug survival of anti-TNF agents when adjustments were made for the effects of other candidate predictors (Hazard ratio: 1.007 (1.002-1.012), p=0.009). CONCLUSION: Our results suggest that compared to the Fc fragment, RF titers were the more important risk factor in survival of anti-TNF drugs.
ABSTRACT
Objectives: The aim of this study was to examine the effect of surgery type and hormone therapy on the general quality of life in breast cancer patients receiving radiotherapy. Material and Methods: A total of 109 patients were included in the study. As data collection tools in the research, a form stating the demographic and clinical features was used in the first part, and in the second part, "EORTC QLQ-C30" developed by the European Organization for Research and Treatment of Cancer and "EORTC QLQ-BR23" Turkish quality of life forms specific to breast cancer were used. The patients were asked to fill in the questionnaire forms on the first day, the last day of radiotherapy and three months after the end of the treatment. Results: Mean age of this study was 54.8 ± 12.1 years. In the questionnaires made on the first day, last day and three months after radiotherapy, the highest score according to the EORTC QLQ-C30 scale was in social and cognitive function, and in sexual life on the EORTC QLQ-BR23 scale. According to multiple comparison test and comparing the first day of radiotherapy and three months after radiotherapy, there was a significant difference in patients' physical function average (p= 0.049), future expectation (p= 0.033), sexual life (p= 0.029), sexual satisfaction (p <0.001), and hair loss (p= 0.011), and arm related problems (p <0.001). According to the analysis of variance in repeated measurements, physical function, sexual life, side effects, hair loss, dyspnea, and future expectation were statistically significant according to the type of surgery, and for hormone therapy, sexual life, hair loss, constipation and financial difficulty were found statistically significant. Conclusion: It was observed that other than radiotherapy, hormone therapy and surgical techniques were also effective on the quality of life in patients receiving radiotherapy for breast cancer.
