Patients' concerns regarding biological agents in rheumatology

Int J Rheum Dis. 2018 Jun;21(6):1219-1226. doi: 10.1111/1756-185X.13319.


Objective: The potential side effects of biological agents may increase the anxiety levels of patients and influence not only their desire to use these therapies but also their concordance to treatment. This study aimed to determine the level and prevalence of drug-related concern in patients treated with biological agents and to acquire additional information regarding the related causes.

Materials and methods: A total of 1134 patients who were using biological agents for at least 3 months with a diagnosis of rheumatic diseases were enrolled. General anxiety levels were evaluated using the State-Trait Anxiety Inventory (STAI).

Results: The most common cause for drug-related concerns was the potential side effects of the drugs (59.5%). Among the potential side effects, cancer risk was the most common cause for concern (40.1%), followed by the risk of tuberculosis activation (30.7%). Anxiety levels were higher in patients who experienced side effects than in other patients, and this difference was statistically significant (P < 0.05). STAI trait and state scores were moderately correlated with anxiety levels related to the drug (P < 0.001).

Conclusion: Anxiety related to biological agents may significantly affect the patients' anxiety levels. Awareness regarding the patients' concerns and expectations related to the drug is important to ensure drug adherence and concordance to treatment.

Keywords: biological agents; patient; patients’ concern; rheumatology.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Anxiety / diagnosis
  • Anxiety / etiology
  • Anxiety / psychology*
  • Biological Products / adverse effects
  • Biological Products / therapeutic use*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Patients / psychology*
  • Rheumatic Diseases / diagnosis
  • Rheumatic Diseases / drug therapy*
  • Rheumatic Diseases / psychology
  • Rheumatology*
  • Risk Factors
  • Surveys and Questionnaires
  • Treatment Outcome
  • Turkey


  • Biological Products