Health-Related Quality of Life in Rheumatoid Arthritis : Systematic Review and Meta-Analysis of EuroQol (EQ-5D) Utility Scores From Asia

Introduction: Region specific Health related quality of life (HRQoL) scores or utility values are representative and pivotal for economic evaluations as they are influenced by value judgement of local population. This study systematically reviewed and pooled EuroQol-5 Dimension (EQ-5D) utility scores of Rheumatoid arthritis (RA) across primary studies from Asia. Methods: Studies reporting EQ-5D utility scores among adult RA patients from Asian countries were systematically searched in PubMed-Medline, Scopus and Embase since inception through February 2020. Selected studies were systematically reviewed and study quality assessment was performed. Meta-analysis was performed using a random-effect model with sub-group and meta-regression analysis to explore heterogeneity.Results: Among 1391 searched, 37 studies with 31,983 participants were systematically reviewed and meta-analysis was conducted among 31 studies. The pooled EQ-5D scores and EQ-5D visual analogue score were 0.66 (95% CI 0.63 to 0.69, I2 = 99.65%) and 61.21 (50.73 to 71.69, I2 = 99.56%) respectively with high heterogeneity. For RA patients with no, low, moderate and high disease activity based on disease activity score (DAS)-28, the pooled EQ-5D scores were 0.78 (0.65 to 0.90), 0.73 (0.65 to 0.80), 0.53 (0.32 to 0.74), and 0.47 (0.32 to 0.62), respectively. On meta-regression, age of patients (p<0.05) was positively associated and use of glucocorticoids (p<0.05) was inversely associated with utility values.Conclusion: Lower EQ-5D scores were associated with severe disease activity, increasing age and female gender among RA patients. The study provides pooled EQ-5D scores RA patients that are useful inputs for cost-utility studies in Asia.Prospero Registration: PROSPERO 2020 CRD42020165263