Anxiety Not Affected by Coping Style in Patients Receiving Rituximab

No difference in anxiety was found among patients with non-Hodgkin lymphoma who were assigned to maintenance rituximab compared with those patients who were assigned to rituximab re-treatment upon disease progression, results of a recent study show.

Study author Lynne I. Wagner, PhD, of Northwestern University Feinberg School of Medicine, and colleagues, called the results of this analysis instructive, informing clinicians that patients assigned to observation may not automatically associate relapse with anxiety if they know that the recurrence will be rapidly treated with a well-tolerated therapy.

"The RESORT results have significant implications for clinical care,” Wagner and colleagues wrote in The Journal of Clinical Oncology." Taken in tandem with findings from this study, clinicians can choose rituximab re-treatment over maintenance rituximab and expect similar patient-centered outcomes while saving resources and achieving similar clinical outcomes."

Patients in the RESORT trial were randomly assigned to maintenance rituximab or rituximab re-treatment. Results of the primary analysis showed no difference in time to treatment failure or disease-related outcomes for the two study arms. In this analysis, the researchers examined whether these treatment assignments affected illness-related anxiety and if this anxiety was dependent on the patient’s coping style.

Patients completed patient-reported outcomes measures at regular intervals between 3 months and 48 months after randomization, and at rituximab failure, if applicable. The outcome measures were designed to assess illness-related anxiety and patient coping style, which was classified as either active or avoidant.

No difference in illness-related anxiety was found between patients in the two study arms at any of the time points examined. This held true for general anxiety, illness-related worry, loss of control, depression, and overall health-related quality of life. Additionally, data showed that the level of illness-related anxiety among all patients decreased throughout the study period.

Seventy percent of patients were classified as having avoidant illness-related coping, with a higher proportion of patients with active coping assigned to the maintenance arm. Regardless of the treatment assignment, those patients with avoidant coping had higher illness-related anxiety and general anxiety compared with patients with active coping. In addition, avoidant coping was associated with higher levels of anxiety at baseline and at 6 months past randomization, as well as poorer health-related quality of life.

"These individuals may benefit from learning active strategies for managing anxiety and worry about progression," the researchers wrote. “Psychosocial interventions, specifically cognitive-behavioral interventions, are highly successful in reducing anxiety and illness-related distress among survivors of cancer."