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Primary Sjögren’s syndrome (pSS) patients identify fatigue as their most important symptom and the one most difficult to cope with, but there are still many challenges and few solutions to manage this debilitating symptom. Promising pharmacological treatments, such as rituximab, have failed in more stringent tests including randomized controlled trials (RCTs) and meta-analysis. While non-pharmacological interventions may be safer, less costly, and address other common comorbidities, to date only aerobic exercise seems to be effective at reducing fatigue in pSS. All interventions, pharmacological or not, need to be tested in high-quality RCTs. The aim of this review is to provide an overview of fatigue management in pSS and discuss potential opportunities for future research.

Sarcoidosis is a multisystem disease with unknown etiology, marked by T lymphocytes and macrophages agglomeration, which leads to the formation of noncaseating granulomas in the affected tissues. We describe a case of a 40-year-old black patient referred to our service for evaluation of nephrolithiasis and persistent elevation of plasma creatinine. He reported important weight loss, fever episodes, and abdominal and low back intermittent pain in the past 6 months. The investigation revealed elevated serum calcium level, hepatosplenomegaly, retroperitoneal lymphadenopathy, anemia, thrombocytopenia, and nephrolithiasis. The initial diagnostic hypothesis was lymphoproliferative disease, but the laparoscopic propaedeutic showed multiple white lesions on the liver surface, which biopsy identified as noncaseating granulomas with asteroid corpuscles, suggestive of sarcoidosis. He was treated with corticosteroids with significant improvement in symptoms and in calcium and creatinine levels. Besides, the patient presented a long-term large joints arthropathy, especially on the knees (with bilateral prosthesis), wrists, and ankles, of unknown etiology. We discuss the systemic manifestations of sarcoidosis related to the reported case, as well as the possible overlapping of idiopathic juvenile arthritis with sarcoidosis.

Paracoccidioidomycosis is an endemic disease in Latin America that is rarely associated with immunosuppression and biological therapy. Herein, we report for the first time a case of pulmonary paracoccidioidomycosis reactivation after infliximab treatment. A 47-year-old man from Brazil received infliximab to treat psoriatic spondyloarthropathy and presented with cough, dyspnea, weight loss, and fever. Chest computed tomography revealed a pulmonary nodule and biopsy confirmed paracoccidioidomycosis. Treatment with sulfamethoxazole and trimethoprim was initiated for fungal infection and infliximab was reintroduced two months later. Considering his clinical improvement and favorable radiologic evolution, antifungal therapy was discontinued after 29 months.

Objetivo: avaliar os resultados da aplicação do Índice de Atividade de Doença da Espondilite Anquilosante de Bath (BASDAI) numa série de pacientes brasileiros com EpA e estabelecer suas correlações com as variáveis específicas do grupo. Métodos: um protocolo comum de investigação foi prospectivamente aplicado em 1.492 pacientes brasileiros classificados como EpA pelos critérios do Grupo Europeu de Estudo das Espondiloartropatias (ESSG), acompanhados em 29 centros de referência em reumatologia no Brasil. Variáveis clínicas, demográficas e índices de doença foram colhidos. Os valores totais do BASDAI foram comparados com a presença das diferentes variáveis. Resultados: o valor médio do BASDAI foi de 4,20 ± 2,38. Os escores médios do BASDAI foram mais elevados nos pacientes com forma clínica combinada, comparado às formas axiais e periféricas isoladas, nos pacientes do sexo feminino e nos sedentários. Com relação ao componente axial, valores mais altos do BASDAI estiveram significativamente associados à lombalgia inflamatória, à dor alternante em nádegas, à dor cervical e ao acometimento de coxofemorais. Houve associação estatística entre os valores do BASDAI e o comprometimento periférico, relacionado ao número de articulações inflamadas, tanto dos membros inferiores quanto dos membros superiores, e às entesites. A positividade do HLA-B27 e a presença de manifestações extra-articulares não estiveram correlacionadas com os valores médios do BASDAI. Valores mais baixos do BASDAI estiveram associados ao uso de agentes biológicos (p < 0,001). Conclusão: nesta série heterogênea de pacientes brasileiros com EpA, o BASDAI conseguiu demonstrar “atividade de doença” tanto nos pacientes com acometimento axial quanto naqueles com envolvimento periférico. Objective: to analyze the results of the application of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in a large series of Brazilian patients with the diagnosis of SpA and establish its correlations with specific variables into the group. Methods: a common protocol of investigation was prospectively applied to 1492 Brazilian patients classified as SpA according to the European Spondyoarthropathies Study Group (ESSG), attended at 29 referral centers of Rheumatology in Brazil. Clinical and demographic variables, and disease indices (BASDAI, Basfi, Basri, Mases, ASQol) were applied. The total values of BASDAI were compared to the presence of the different variables. Results: the mean score of BASDAI was 4.20 ± 2.38. The mean scores of BASDAI were higher in patients with the combined (axial + peripheral + entheseal) (4.54 ± 2.38) clinical presentation, compared to the pure axial (3.78 ± 2.27) or pure peripheral (4.00 ± 2.38) clinical presentations (P < 0.001). BASDAI also presented higher scores associated with the female gender (P < 0.001) and patients who did not practice exercises (P < 0.001). Regarding the axial component, higher values of BASDAI were significantly associated with inflammatory low back pain (P < 0.049), alternating buttock pain (P < 0.001), cervical pain (P < 0.001) and hip involvement (P < 0.001). There was also statistical association between BASDAI scores and the peripheral involvement, related to the lower (P = 0.004) and upper limbs (P = 0.025). The presence of enthesitis was also associated to higher scores of BASDAI (P = 0.040). Positive HLA-B27 and the presence of cutaneous psoriasis, inflammatory bowel disease, uveitis and urethritis were not correlated with the mean scores of BASDAI. Lower scores of BASDAI were associated with the use of biologic agents (P < 0.001). Conclusion: in this heterogeneous Brazilian series of SpA patients, BASDAI was able to demonstrate “disease activity” in patients with axial as well as peripheral disease.

ObjectiveTo analyze the clinical and epidemiologic characteristics of juvenile-onset spondyloarthritis (SpA) (< 16 years) and compare them with a group of adult-onset (≥ 16 years) SpA patients.Patients and methodsProspective, observational and multicentric cohort with 1,424 patients with the diagnosis of SpA according to the European Spondyloarthropathy Study Group (ESSG) submitted to a common protocol of investigation and recruited in 29 reference centers participants of the Brazilian Registry of Spondyloarthritis (RBE – Registro Brasileiro de Espondiloartrites). Patients were divided in two groups: age at onset

Avaliar os efeitos do treinamento aeróbico e do alongamento sobre os níveis séricos de serotonina (5-HT) e seu principal metabólito ácido 5-hidroxiindolacético (5-HIAA). Foram randomizadas 22 mulheres com fibromialgia (FM) em uma de duas modalidades de exercício (exercício aeróbico de caminhada ou exercício de alongamento) a serem realizadas três vezes por semana, por 20 semanas. Os níveis séricos de 5-HT e 5-HIAA foram avaliados antes e após o programa de exercícios por cromatografia líquida de alta eficiência (CLAE) com detecção colorimétrica. A análise de grupo (pré-pós) mostrou que os níveis séricos de 5-HT e 5-HIAA mudaram significativamente no grupo aeróbico durante o período de 20 semanas de terapia (5-HT: p = 0,03; 5-HIAA: p = 0,003). No grupo alongamento, contudo, não foi observada qualquer alteração estatisticamente significativa (5-HT: p = 0,491; 5-HIAA: p = 0,549). Comparações estatísticas das medidas de laboratório entre os grupos constataram que o treinamento aeróbico foi superior ao alongamento, aumentando significativamente os níveis de 5-HIAA (teste F - 6,61; p = 0,01); porém, a diferença média entre os grupos a respeito dos níveis de 5-HT não atendeu aos critérios de relevância (teste F = 3,42; p = 0,08). O treinamento aeróbico aumenta os níveis de 5-HIAA e 5-HT e poderia explicar porque o exercício aeróbico pode melhorar os sintomas de pacientes com síndrome de fibromialgia mais que o exercício de alongamento. To evaluate the effects of aerobic training and stretching on serum levels of serotonin (5HT) and its main metabolite 5-hydroxindolacetic acid (5HIAA). Twenty-two women with FM were randomized into one of two exercise modalities (aerobic walking exercise or stretching exercise) to be accomplished three times a week for 20 weeks. The serum levels of 5HT and 5HIAA were evaluated before and after the exercise program by high performance liquid chromatography (HPLC) with colorimetric detection. Within group analysis (pre-post) showed that serum levels of both 5HT and 5HIAA changed signifi cantly in the aerobic group during the 20-week course of therapy (5HT: P = 0,03; 5HIAA: P = 0,003). In the stretching group, however, no statistically signifi cant change was observed (5HT: P=0,491; 5HIAA: P=0,549). Between group statistical comparisons of laboratory measures disclosed that aerobic training was superior to stretching in that it signifi - cantly increased the levels of 5HIAA (F test = 6.61; P = 0.01), but the average difference between groups on the levels of 5HT did not meet signifi cance criteria (F test = 3.42; P = 0.08). Aerobic training increases the 5HIAA and 5HT levels and it could explain why aerobic exercise can improve symptoms in fi bromyalgia syndrome patient more than stretching exercise

ObjectiveTo perform a cross-cultural adaptation and validation of the Profile of Fatigue and Discomfort – Sicca Symptoms Inventory (short form) (PROFAD-SSI-SF) questionnaire assessing the subjective aspects of the symptoms of primary Sjögren syndrome (pSS), for the Brazilian Portuguese language.MethodConceptual, of the item, semantic and operational equivalences were evaluated. The Brazilian version of PROFAD-SSI-SF was administered to 62 women with pSS according to the European-American consensus 2002 to assess measurement equivalence. α-Cronbach was used for internal consistency; intraclass correlation coefficient (ICC) for intraobserver reproducibility; and Spearman correlation coefficient for validity by comparing with Patient Global Assessment (PaGA), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-F) and EuroQOL (EQ-5D).ResultsThe internal consistency of PROFAD, SSI and total score was 0.80; 0.78; and 0.87, respectively. The intraobserver reproducibility of total PROFAD was 0.89; of total SSI was 0.86; and total score was 0.89. In terms of validity, PROFAD correlated significantly with PaGA (r=0.50), FACIT-F (r=0.59), ESSPRI (r=0.58) and all domains of EQ-5D, with the exception of Mobility. On the other hand, SSI correlated significantly with PaGA (r=0.43), FACIT-F (r=0.57), ESSPRI (r=0.55) and most domains of EQ-5D. The total score of PROFAD-SSI-SF had a non-statistically significant correlation only with Mobility domain and with 1–100 range of EQ-5D.ConclusionThe Portuguese version of PROFAD-SSI-SF proved to be an adaptable, reproducible and valid tool for the Brazilian Portuguese language.

Não há estudo anterior sobre a prevalência de síndrome de Sjögren (SS) no Brasil. O objetivo deste estudo foi avaliar a prevalência de SS na população geral de Vitória, estado do Espírito Santo, Brasil. Trata-se de estudo epidemiológico, observacional e transversal com 1.205 indivíduos randomizados, cujas idades variaram de 18 a 65 anos, residentes em Vitória. Os indivíduos foram triados para xerostomia e xeroftalmia por meio de entrevista domiciliar. Aqueles com sintomas "sicca" foram convidados a comparecer ao hospital para realizar avaliação médica adicional, avaliação do fluxo salivar não estimulado, teste de Schirmer I, exame de sangue e biopsia de glândula salivar labial menor. Os sintomas "sicca" foram identificados em 18% (217 indivíduos) da amostra. Dos 217 indivíduos com sintomas "sicca", 127 (58%) estavam disponíveis para exame. Nessa amostra, 61,7% eram mulheres e 46,8% usavam medicação. A síndrome "sicca" foi confirmada em 12% deles por pelo menos um exame (fluxo salivar ou teste de Schirmer I). Dois pacientes (0,17%) preencheram quatro critérios classificatórios americano-europeus (95% IC = 0,020-0,5983). There has been no previous prevalence study about of Sjögren's syndrome (SS) in Brazil. The aim was to evaluate the SS prevalence in a general population in Vitória, ES, Brazil. This was an epidemiological, observational, and cross-sectional study conducted on 1,205 randomized people, aged 18-65 years, who lived in Vitória. The subjects were screened for xerostomia and xerofphthalmia through home interviews. Those with sicca symptoms were asked to report to a hospital for further medical evaluation, unstimulated salivary flow, Schirmer I test, blood analysis and minor labial salivary biopsy. Sicca symptoms were found in 18% (217 subjects) of the sample. Of the 217 subjects with sicca symptoms, 127 (58%) were available for examination. In this sample, 61.7% were female and 46.8% were under medication. Sicca syndrome was confirmed in 12% by at least one examination (salivary flow or Schirmer I). Two patients (0.17%) matched four criteria according to American-European Criteria (95% CI = 0.020-0.5983).

Acute fibrinous and organizing pneumonia (AFOP), recently described, is a histologic pattern characterized by the presence of fibrin “balls” within alveolar spaces. The term undifferentiated connective tissue disease (UCTD) is used to identify autoimmune systemic diseases that do not fulfill the criteria to be classified as a definitive connective tissue disease. The AFOP has never been reported in association with UCTD. The present reported case is a 39-year-old Caucasian, female with dry cough and progressive dyspnea. Eight months later, she was diagnosed with “organizing pneumonia” based on clinical history and radiologic images. She manifested Raynaud’s Phenomenon, sicca syndrome, boot and gloves neuropathic pain, and previous hypothyroidism. Antinuclear antibody, rheumatoid factor, and specific autoantibodies were negative. Salivary gland biopsy and electroneuromyiography were normal. The capillaroscopy showed a “scleroderma” pattern with capillary deletion and ectasia. She experienced clinical and radiologic worsening. Despite being submitted to cyclophosphamide pulse, she developed hemorrhage and then died. Thoracotomy pulmonary specimen showed histological pattern of AFOP. This paper shows a rare association of AFOP with UCTD.

OBJECTIVE: To evaluate the use of a static positioning orthesis for boutonnière deformity on the thumb. METHODS: Twenty women aged between 25 and 74 years old were included in the study. They were distributed at random into a control group and a group using orthesis. Pinch and Jamar's dynamometers, Pain Visual Scale and O'Connor's Functional Evaluation were applied to all patients. Wilcoxon's, Mann Whitney's and Scheffe's tests were used for the statistical analysis. RESULTS: After 30 days in the intra-group analysis, there was functional improvement, evaluated by O'Connor's test in 40% of the controls and 70% of these patients using orthesis. There was no statistically significant difference between the groups in any of the evaluated parameters. CONCLUSIONS: These results suggest that orthesis is beneficial to the functional improvement; the tested model was comfortable and well accepted by patients. Nevertheless, subsequent studies of longer duration and including more subjects are needed. OBJETIVO: avaliar o uso de uma órtese estática de posicionamento para a deformidade em botoeira no polegar. MÉTODOS: foram incluídas mulheres com idade entre 25 e 74 anos e distribuídas de modo aleatório em grupo controle ou grupo usando órteses. Os instrumentos de avaliação utilizados foram os dinamômetros Pinch e Jamar, a escala visual de dor e o teste funcional de O'Connor. Na análise estatística foram utilizados os testes de Wilcoxon, de Mann Whitney e de Scheffe. RESULTADOS: após 30 dias, na análise intragrupo houve uma melhora funcional, como medido pelo teste de O'Connor, em 40% do controle e 70% dos pacientes que usaram órteses. Não houve diferença estatisticamente significante entre os grupos em nenhum dos parâmetros avaliados. CONCLUSÕES: esses resultados sugerem que a órtese é benéfica na melhora funcional e o modelo testado foi confortável e bem tolerado pelos pacientes. Porém, é necessário um estudo subseqüente, mais extenso e incluindo maior número de pacientes.

Submitted by Elizabete Silva (elizabete.silva@ufes.br) on 2014-12-01T18:23:58Z No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertacao. Flavia Garcia Pereira.pdf: 1824139 bytes, checksum: 1a91d98bd9d2cdb9a8893aa41220e207 (MD5) Approved for entry into archive by Elizabete Silva (elizabete.silva@ufes.br) on 2014-12-05T16:46:27Z (GMT) No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertacao. Flavia Garcia Pereira.pdf: 1824139 bytes, checksum: 1a91d98bd9d2cdb9a8893aa41220e207 (MD5) Made available in DSpace on 2014-12-05T16:46:27Z (GMT). No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertacao. Flavia Garcia Pereira.pdf: 1824139 bytes, checksum: 1a91d98bd9d2cdb9a8893aa41220e207 (MD5) Previous issue date: 2014 A associação entre experiências adversas na infância e o desencadeamento de depressão ou dor crônica na vida adulta tem sido documentada, assim como a relação entre os sintomas de dor crônica e depressão. No entanto, há poucos estudos avaliando o papel da exposição a experiências adversas na infância na ocorrência dessa comorbidade. O objetivo deste trabalho é avaliar a influência da exposição a experiências adversas na infância na ocorrência de dor crônica, de depressão e na comorbidade dor crônica e depressão na vida adulta, em uma amostra da população geral adulta (maiores de 18 anos) residente na Região metropolitana de São Paulo, Brasil. Os dados são resultantes do Estudo Epidemiológicos dos Transtornos Mentais São Paulo Megacity. Os respondentes foram avaliados usando a versão desenvolvida para o Estudo Mundial de Saúde Mental do Composite International Diagnostic Interview da Organização Mundial da Saúde (WMH-CIDI), que é composto por módulos clínicos e nãoclínicos provendo diagnósticos de acordo com os critérios do Manual Diagnóstico e Estatístico dos Transtornos Mentais 4ª edição (DSM-IV). Um total de 5.037 indivíduos foi entrevistado, com uma taxa global de resposta de 81,3%. Foram realizadas análises descritivas para médias e proporções, e associações (Razões de Chances – OR) entre experiências adversas na infância, dor crônica e depressão através de regressão logística. Todas as análises foram realizadas através do programa estatístico Data Analysis and Statistical Software versão 12.0 (STATA 12.0), com testes bi-caudais com nível de significância de 5%. Uma elevada taxa de prevalência de dor crônica (31%, Erro Padrão [ER]=0.8) foi encontrada, Dor Crônica esteve associada aos transtornos de ansiedade (OR=2,3; 95% IC=1,9 – 3,0), transtornos de humor (OR=3,3; IC=2,6 – 4,4) em qualquer transtorno mental (OR=2,7; 95% IC=2,3 – 3,3). As adversidades na infância estiveram fortemente associadas aos respondentes com dor crônica e depressão concomitante, principalmente quanto ao abuso físico (OR=2,7; 95% IC=2,1 – 3,5) e sexual (OR=7,4; 95% IC=3,4 – 16,1). Association between adverse childhood experiences and onset- depression or chronic pain in adulthood has been documented, as well as the relationship between symptoms of comorbidity chronic pain and depression. However, the literature is extremely limited about the interaction of adverse childhood experiences in this comorbidity. The objective of this study is to evaluate the influence of adverse childhood experiences in depression, chronic pain and on the comorbidity of chronic pain and depression in adulthood in a probabilistic sample of household adult residents in the Sao Paulo Metropolitan Area, Brazil. The data were resulting from the São Paulo Megacity Mental Health Survey. Respondents were assessed using the World Mental Health Survey version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI), which comprises clinical and no-clinical sections producing diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV). A total of 5,037 individuals were interviewed, with a global response rate of 81.3%. Descriptive analysis for means and proportions were performed, and associations between adverse childhood experiences, chronic pain and depression were performed using logistic regression with statistical software Data Analysis and Statistical Software version 12.0 (STATA 12.0), using 0.05 level two-sided tests. High prevalence of chronic pain (31%, standard error [ER] = 0.8) was found. Chronic pain was associated to anxiety disorders (OR 2.3, 95% CI 1.9-3.0), mood disorders (OR 3.3; 95% CI 2.6-4.4) in any mental disorder (OR 2.7; 95% CI 2.3-3.3). The childhood adversities were strongly associated with comorbidity chronic pain and depression, especially physical abuse (OR 2.7, 95% CI 2.1-3.5) and sexual abuse (OR 7.4, 95% CI 3.4-16.1).

Made available in DSpace on 2016-12-23T13:46:57Z (GMT). No. of bitstreams: 1 Erica Vieira Serrano.pdf: 1290263 bytes, checksum: 97d4b3362a8eb6c3ab6057f6d6c97b1b (MD5) Previous issue date: 2012-11-05 Introduction: The EULAR Sjögren s Syndrome Disease Activity Index (ESSDAI) is a composite index to assess systemic activity of primary Sjögren s Syndrome (SSP) created in 2009 and it does not have any cultural adaptation to Portuguese language. Objective: To perform the cultural adaptation of ESSDAI for Brazilian Portuguese. Methods: Cross-sectional observational study with patients with SSP according to the European American Consensus 2002. In the adaptation process, there were six steps: conceptual equivalence, item, semantic, operational, measurement and functional. Semantic equivalence included translation, back translation, evaluation of semantics between the original and back translations, discussion with experts for final adjustments and pre-test of consensual version in twenty patients. In measurement equivalence, the psychometric properties of internal consistency, interobserver reproducibility and construct validity were assessed in 62 subjects. For the construct validity, the ESSDAI was compared with the Physician s Global Assessment (PhGA), the Sjögren s Syndrome Disease Activity Index (SSDAI), the Sjögren s Systemic Clinical Activity Index (SCAI), between groups "active" and "inactive" defined by expert and according to intention to treat, the groups "increase therapy" and "no increase in therapy." Statistical tests used were Cronbach s α for internal consistency, the intraclass correlation coefficient and Bland Altman analysis for interobserver reproducibility, and the Spearman coefficient and Mann-Whitney test for validity (p

Made available in DSpace on 2016-12-23T13:47:03Z (GMT). No. of bitstreams: 1 Wellington Bezerra Prates.pdf: 2688972 bytes, checksum: 7902cafdc7f9638375bbba5ce95b9baa (MD5) Previous issue date: 2012-05-20 Rheumatoid arthritis is the most common musculoskeletal inflammatory, autoimmune, and progressive disease that along with functional disability over the years can lead to, a decline in quality of life due to labor, social and psychological damages. This study aimed at evaluating patients diagnosed with rheumatoid arthritis in biological therapy, in the State of Espirito Santo considering their quality of life and other intervening factors. This is a cross-sectional study using primary and secondary data from 171 patients treated with biologics in a rheumatology outpatient clinic of a university hospital. Sociodemographic, clinical (disease activity, functional capacity, pain and fatigue assessment) and quality of life variables were evaluated. The instruments used were DAS-28, VAS global, of pain and fatigue, Stanford Health Assessment Questionnaire (HAQ) and WHOQOL-bref and biochemical tests for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP). For data treatment, Spearman correlation coefficient was used for analysis of the WHOQOL-bref with continuous variables, and the Mann-Whitney and Kruskal-Wallis test for categorical variables with significance level of 5%. The results showed that most patients were female (90.1%), they had from 9 to11 years of education (33.3%), retired or on work leave (49.1%), and belonging to economic class C (47.4 %). Clinical variables were consistent presenting moderate averages in disease acitivity (DAS-28: 3,8±1,5), HAQ (1,05±0,74) e EVA Global (42,5±28,3). Averages presented mild pain (37 ± 27,6) and fatigue (37,1 ± 31,2). The WHOQOL-bref domain with the lowest rate was the physical one (49.7±17.5) and the one showing highest rates was the social domain (68.6 ± 21). In the inferential analysis there was significant difference between the four domains of WHOQOL-bref and sex, years of education, employment status, and economic class (p < 0.05). Correlations between HAQ (r: - 0,717, p < 0.05), DAS-28 (r: -0,557, p < 0.05), general VAS (r: -0,551, p < 0.05), pain (r: -0,547, p < 0.05), fatigue (r: -0,463, p < 0.05) and the four domains of WHOQOLbref. We conclude that patients presented altered clinical parameters and impaired quality of life, especially in the physical domain A artrite reumatóide é a mais comum das doenças inflamatórias músculoesqueléticas, de natureza auto-imune, progressiva e pode levar juntamente com a incapacidade funcional ao longo dos anos, a diminuição da qualidade de vida devido aos danos laborais, sociais e psicológicos. O estudo objetivou avaliar os pacientes com diagnóstico de artrite reumatóide, em terapia biológica, no estado do Espírito Santo quanto à qualidade de vida e os fatores intervenientes. Estudo transversal com dados primários e secundários dos 171 pacientes em tratamento com biológicos em ambulatório de reumatologia de um hospital universitário. As variáveis avaliadas foram as sociodemográficas, as clínicas (atividade da doença, capacidade funcional, avaliação de dor e fadiga) e a qualidade de vida. Utilizado os instrumentos DAS-28, EVA Global, Eva Dor, Eva Fadiga, Stanford Health Assessment Questionnaire (HAQ) e WHOQOL-bref e exames bioquímicos para fator reumatóide e o anticorpo anti-peptídeo citrulinado cíclico (anti-CCP). O tratamento dos dados utilizou o coeficiente de correlação de Spearman para análise do WHOQOL-bref com as variáveis contínuas e os de Mann-Whitney e Kruskal-Wallis para as variáveis categóricas, com nível de significância de 5%. Os resultados evidenciaram que a maioria era do sexo feminino (90,1%), 9 a 11 anos de estudo (33,3%), aposentados e afastados do serviço (49,1%), e classe econômica C (47,4%). Nas variáveis clínicas as médias foram compatíveis com moderada em atividade da doença (DAS-28: 3,8±1,5), HAQ (1,05±0,74) e EVA Global (42,5±28,3). Dor (37 ± 27,6) e fadiga (37,1 ± 31,2) apresentaram médias compatíveis com quadro leve. O domínio do WHOQOL-bref com menor pontuação foi o físico (49,7 ± 17,5) e o com maior foi o social (68,6 ± 21). Na análise inferencial houve diferença significante (p valor < 0,05) dos quatro domínios do WHOQOL-bref com o sexo, anos de estudo, situação profissional e classe econômica. Foram identificadas correlações do HAQ (r: -0,717, p < 0.05), DAS-28 (r: -0,557, p < 0.05), EVA Global (r: -0,551, p < 0.05), fadiga (r: - 0,463, p < 0.05), dor (r: -0,547, p < 0.05), articulações dolorosas e edemaciadas com os quatro domínios do WHOQOL-bref. Conclui-se que os pacientes estavam com parâmetros clínicos alterados e qualidade de vida comprometida, especialmente no domínio físico