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Functional disability can deteriorate despite suppression of disease activity in patients with rheumatoid arthritis: a large observational cohort study.
MedLine Citation:
PMID:  23319067     Owner:  NLM     Status:  Publisher    
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.
Yohei Seto; Eisuke Inoue; Kumi Shidara; Daisuke Hoshi; Naoki Sugimoto; Eri Sato; Eiichi Tanaka; Ayako Nakajima; Atsuo Taniguchi; Shigeki Momohara; Hisashi Yamanaka
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-16
Journal Detail:
Title:  Modern rheumatology / the Japan Rheumatism Association     Volume:  -     ISSN:  1439-7609     ISO Abbreviation:  Mod Rheumatol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100959226     Medline TA:  Mod Rheumatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan,
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