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Mod Rheumatol. 2013 Nov;23(6):1179-85. doi: 10.1007/s10165-012-0816-5. Epub 2013 Jan 16.

Functional disability can deteriorate despite suppression of disease activity in patients with rheumatoid arthritis: a large observational cohort study.

Author information

  • 1Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan, seto@ior.twmu.ac.jp.

Abstract

OBJECTIVE:

To analyze the relationship between the progression of disability and disease activity in patients with rheumatoid arthritis (RA) in daily practice.

METHODS:

Patients from an observational cohort, IORRA, who completed surveys during 2009-2011 were eligible. Linear regression of disease activity score 28 (DAS28), Japanese version of Health Assessment Questionnaire (J-HAQ), and EQ-5D from baseline were calculated, and the angles of the regression lines were designated DAS28 slope, J-HAQ slope, and EQ-5D slope, respectively, in each patient; averages were compared between treatment groups.

RESULTS:

A total of 5,038 patients [84.0% female, mean age 59.4 (SD 13.1) years, disease duration 13.2 (9.6) years, DAS28 3.29 (1.14), and J-HAQ 0.715 (0.760)] were analyzed. The average DAS28 slope indicated improvement in all groups, whereas J-HAQ slopes were negative in patients on methotrexate (MTX), biologics, combination biologics/disease-modifying antirheumatic drugs (DMARDs), and combination biologics/MTX at baseline, but positive in patients on prednisolone >5 mg/day [0.010 (0.153)] and not on MTX at baseline [0.007 (0.122)], representing a worsening of disability.

CONCLUSION:

There is some disparity between improvement of disease activity and progression of disability, suggesting that quality of remission must be considered.

PMID:
23319067
[PubMed - in process]
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