Factors Associated with Five-year Deterioration of the Health Assessment Questionnaire-Disability Index in Patients with Rheumatoid Arthritis: A Retrospective Cohort Study

Overview

Journal Intern Med

Specialty General Medicine

Date 2022 Nov 3

PMID 36328576

Authors

Takeshi Mochizuki

Koichiro Yano

Katsunori Ikari

Ken Okazaki

Affiliations

Soon will be listed here.

Abstract

Objectives We investigated the factors associated with the deterioration of the Health Assessment Questionnaire-Disability Index (HAQ-DI) over five years in patients with rheumatoid arthritis (RA). Methods Clinical data were obtained from 391 patients who were classified into 2 groups: a group with HAQ-DI deterioration (in which the HAQ-DI had worsened) and a group without HAQ-DI deterioration. A multivariable logistic regression analyses of the age, sex, disease duration, body mass index, anti-cyclic citrullinated peptide antibody, the use of biological disease-modifying antirheumatic drugs or targeted synthetic disease-modifying antirheumatic drugs, methotrexate use, glucocorticoid use, C-reactive protein, pain visual analog scale (pain VAS), disease activity score 28 erythrocyte sedimentation rate (DAS28-ESR), the HAQ-DI, and van der Heijde modified total Sharp score was performed at baseline and five years to determine significant factors associated with the HAQ-DI. Results The significant factors associated with HAQ-DI deterioration were age [odds ratio (OR): 1.05; 95% confidence interval (CI): 1.02-1.08], glucocorticoid use (OR: 1.95; 95% CI: 1.03-3.71), DAS28-ESR (OR: 1.92; 95% CI: 1.33-2.79), change in pain VAS from baseline (OR: 1.02; 95% CI: 1.01-1.04), and change in DAS28-ESR from baseline (OR: 1.67; 95% CI: 1.15-2.44). Conclusion The present study suggests that glucocorticoid tapering as well as disease activity and pain control are required to prevent deterioration of the HAQ-DI in patients with RA.

References

Drossaers-Bakker K, de Buck M, van Zeben D, Zwinderman A, Breedveld F, Hazes J . Long-term course and outcome of functional capacity in rheumatoid arthritis: the effect of disease activity and radiologic damage over time. Arthritis Rheum. 1999; 42(9):1854-60. DOI: 10.1002/1529-0131(199909)42:9<1854::AID-ANR9>3.0.CO;2-F. View

Schakman O, Kalista S, Barbe C, Loumaye A, Thissen J . Glucocorticoid-induced skeletal muscle atrophy. Int J Biochem Cell Biol. 2013; 45(10):2163-72. DOI: 10.1016/j.biocel.2013.05.036. View

Hallert E, Bjork M, Dahlstrom O, Skogh T, Thyberg I . Disease activity and disability in women and men with early rheumatoid arthritis (RA): an 8-year followup of a Swedish early RA project. Arthritis Care Res (Hoboken). 2012; 64(8):1101-7. DOI: 10.1002/acr.21662. View

Gwinnutt J, Symmons D, MacGregor A, Chipping J, Marshall T, Lunt M . Twenty-Year Outcome and Association Between Early Treatment and Mortality and Disability in an Inception Cohort of Patients With Rheumatoid Arthritis: Results From the Norfolk Arthritis Register. Arthritis Rheumatol. 2017; 69(8):1566-1575. PMC: 5600136. DOI: 10.1002/art.40090. View

Koevoets R, Dirven L, Klarenbeek N, van Krugten M, Ronday H, van der Heijde D . 'Insights in the relationship of joint space narrowing versus erosive joint damage and physical functioning of patients with RA'. Ann Rheum Dis. 2012; 72(6):870-4. DOI: 10.1136/annrheumdis-2011-201191. View

Bruce B, Fries J . The Stanford Health Assessment Questionnaire: a review of its history, issues, progress, and documentation. J Rheumatol. 2003; 30(1):167-78. View

Smolen J, Aletaha D, Grisar J, Stamm T, Sharp J . Estimation of a numerical value for joint damage-related physical disability in rheumatoid arthritis clinical trials. Ann Rheum Dis. 2009; 69(6):1058-64. DOI: 10.1136/ard.2009.114652. View

Kroot E, de Jong B, van Leeuwen M, Swinkels H, van den Hoogen F, Vant Hof M . The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis. Arthritis Rheum. 2000; 43(8):1831-5. DOI: 10.1002/1529-0131(200008)43:8<1831::AID-ANR19>3.0.CO;2-6. View

Sokka T, Kautiainen H, Hannonen P, Pincus T . Changes in Health Assessment Questionnaire disability scores over five years in patients with rheumatoid arthritis compared with the general population. Arthritis Rheum. 2006; 54(10):3113-8. DOI: 10.1002/art.22130. View

10.

Aletaha D, Neogi T, Silman A, Funovits J, Felson D, Bingham 3rd C . 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010; 62(9):2569-81. DOI: 10.1002/art.27584. View

11.

Scott D, Grindulis K, Struthers G, Coulton B, POPERT A, Bacon P . Progression of radiological changes in rheumatoid arthritis. Ann Rheum Dis. 1984; 43(1):8-17. PMC: 1001208. DOI: 10.1136/ard.43.1.8. View

12.

Fries J, Spitz P, Kraines R, HOLMAN H . Measurement of patient outcome in arthritis. Arthritis Rheum. 1980; 23(2):137-45. DOI: 10.1002/art.1780230202. View

13.

Welsing P, van Gestel A, Swinkels H, Kiemeney L, van Riel P . The relationship between disease activity, joint destruction, and functional capacity over the course of rheumatoid arthritis. Arthritis Rheum. 2001; 44(9):2009-17. DOI: 10.1002/1529-0131(200109)44:9<2009::AID-ART349>3.0.CO;2-L. View

14.

Combe B, Rincheval N, Benessiano J, Berenbaum F, Cantagrel A, Daures J . Five-year favorable outcome of patients with early rheumatoid arthritis in the 2000s: data from the ESPOIR cohort. J Rheumatol. 2013; 40(10):1650-7. DOI: 10.3899/jrheum.121515. View

15.

van der Heijde D . Radiographic progression in rheumatoid arthritis: does it reflect outcome? Does it reflect treatment?. Ann Rheum Dis. 2002; 60 Suppl 3:iii47-50. PMC: 1766669. DOI: 10.1136/ard.60.90003.iii47. View

16.

Sokka T, Kankainen A, Hannonen P . Scores for functional disability in patients with rheumatoid arthritis are correlated at higher levels with pain scores than with radiographic scores. Arthritis Rheum. 2000; 43(2):386-9. DOI: 10.1002/1529-0131(200002)43:2<386::AID-ANR19>3.0.CO;2-Z. View

17.

Hasselgren P, Alamdari N, Aversa Z, Gonnella P, Smith I, Tizio S . Corticosteroids and muscle wasting: role of transcription factors, nuclear cofactors, and hyperacetylation. Curr Opin Clin Nutr Metab Care. 2010; 13(4):423-8. PMC: 2911625. DOI: 10.1097/MCO.0b013e32833a5107. View

18.

Arnett F, Edworthy S, Bloch D, McShane D, Fries J, Cooper N . The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988; 31(3):315-24. DOI: 10.1002/art.1780310302. View

19.

Scott D, Pugner K, Kaarela K, Doyle D, Woolf A, Holmes J . The links between joint damage and disability in rheumatoid arthritis. Rheumatology (Oxford). 2000; 39(2):122-32. DOI: 10.1093/rheumatology/39.2.122. View

20.

Gupta A, Gupta Y . Glucocorticoid-induced myopathy: Pathophysiology, diagnosis, and treatment. Indian J Endocrinol Metab. 2013; 17(5):913-6. PMC: 3784879. DOI: 10.4103/2230-8210.117215. View