Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Aiming To Reach RemissionIs It Worthwhile?
Radner3, Helga, Smolen1, Josef S., Aletaha2, Daniel
Rheumatoid arthritis (RA) is a prevalent chronic inflammatory disease causing disability and a considerable burden for the single patient and society. Remission (REM) is one of the major goals of RA treatment. In this study, we investigated whether in patients with low disease activity aiming for remission is also effective from a socio-economic point of view.
Patients and Methods:
In 356 patients with established RA we obtained information about quality of life (Short Form 36, SF-36), utility (Short Form 6D, SF-6D; Euro-Quol 5D, EQ-5D), physical disability (Health Assessment Questionnaire, HAQ), productivity (Work productivity and activity impairment Questionnaire, WPAI), as well as disease activity (Clinical Disease Activity Index, CDAI). In cross-sectional analyses we compared data obtained of patients in REM (n=89) to those in LDA (n=152) using Students T-Test. We also compared patients who stayed in REM (n=34) for a whole year and compared their values with those of patients in LDA (n=66) for the same period.
In the cross-sectional analyses we found statistically significant differences of utilities when comparing patients in REM with those in LDA (SF-6D 0.75 vs. 0.66; EQ-5D 0.89 vs. 0.78), physical disability (HAQ 0.38 vs. 0.75) and productivity (WPAI % overall impairment: 18.1% vs. 33.8%; WPAI % impairment while working: 11.3% vs. 27.2%) (all comparisons: p<0.05?). Regarding quality of life we found significant differences in all domains except role emotional and MCS in favor of REM. Though, compared to healthy populations there are still significant differences in all domains except mental health figure.
Figure 1. Domains of Short Form 36 in patients within REM compared to LDA and healthy control.
Abbreviations: BP bodily pain; PF physical function; RP role physical, GHP general health perception; SF social function; MH mental health; RE role emotional, VT vitality.
Preliminary longitudinal analyses showed significant differences of outcomes over one year between patients in REM and those in LDA: QALY (SF-6D 0.89 vs. 0.80; EQ-5D 0.80 vs. 0.66), Quality of life over one year (PCS 48.7 vs. 38.0), physical disability over one year (HAQ 0.22 vs. 0.69), and percent of overall activity impairment per year (12.2% vs. 31.0%). No significant difference of percent of activity impairment while working was found.
From a socio-economic perspective including quality of life, disability, and productivity, REM seems to be still superior to any other state of disease, even LDA. Therefore aiming for REM seems worthwhile and should be the major target when treating RA.
To cite this abstract, please use the following information:
Radner, Helga, Smolen, Josef S., Aletaha, Daniel; Aiming To Reach RemissionIs It Worthwhile? [abstract]. Arthritis Rheum 2010;62 Suppl 10 :296