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Rheumatoid arthritis patients with low baseline Health Assessment Questionnaire scores have a risk of functional disability progression: a post hoc analysis of a nationwide longitudinal cohort in Japan

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26

 

  1. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  2. Department of Rheumatology, Zenjinkai Shimin-no-Mori Hospital, Miyazaki, Japan.
  3. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, and Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. tkoga@nagasaki-u.ac.jp
  4. Department of Rheumatology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
  5. Department of Rheumatology, Tenjinkai Koga Hospital 21, Kurume, Japan.
  6. Department of Haematology and Rheumatology, Tohoku University Hospital, Sendai, Japan.
  7. Rheumatic and Collagen Disease Center, Sasebo Chuo Hospital, Sasebo, Japan.
  8. Department of Haematology and Rheumatology, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Japan.
  9. Department of Rheumatology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, and Department of Rheumatology, Kurume University Medical Center, Kurume, Japan.
  10. Yu Family Clinic, Miyagi, Japan.
  11. Department of Rheumatology, Kurume University Hospital, Kurume, Japan.
  12. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, and Department of General and Internal Medicine, Rheumatology, National Hospital Organization, Nagasaki Medical Center, Omura, Japan.
  13. Department of Haematology and Rheumatology, Tohoku University Hospital, Sendai, Japan.
  14. Department of Orthopaedic Surgery, Tohoku University Hospital, Sendai, Japan.
  15. Department of Rheumatology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, and Rheumatic and Collagen Disease Center, Sasebo Chuo Hospital, Sasebo, Japan.
  16. Higashisendai Rheumatic Disease Clinic, Miyagino, Sendai, Japan.
  17. Osaki Citizen Hospital, Osaki, Japan.
  18. Department of General and Internal Medicine, Rheumatology, National Hospital Organization, Nagasaki Medical Center, Omura, and Miyashita Rheumatology Clinic, Omura, Japan.
  19. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, and Department of Community Medicine, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  20. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  21. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  22. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  23. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  24. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, and Department of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  25. Rheumatic and Collagen Disease Center, Sasebo Chuo Hospital, Sasebo, and Sasebo City General Hospital, Sasebo, Japan.
  26. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

and the Japanese RA Patients with RRP Study Group

CER12947
2020 Vol.38, N°6
PI 1096, PF 1101
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PMID: 32896260 [PubMed]

Received: 13/11/2019
Accepted : 13/01/2020
In Press: 01/09/2020
Published: 03/12/2020

Abstract

OBJECTIVES:
To determine prognostic factors for the Health Assessment Questionnaire-Disability Index (HAQ-DI) progression in patients with rheumatoid arthritis (RA) in clinical practice.
METHODS:
We evaluated 388 biological disease-modifying anti-rheumatic drug (bDMARD)-naïve Japanese patients with RA with moderate to high disease activity at study entry after being treated with conventional synthetic DMARDs. These patients were treated according to a treat-to-target (T2T) strategy for one year. The Disease Activity Score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR) and the HAQ-DI were assessed every three months. We also evaluated joint destruction using a modified total Sharp score at baseline and at one year. HAQ-DI progression was defined as the yearly progression of HAQ-DI >0.1. We performed a multiple logistic regression analysis to explore the factors predicting HAQ-DI progression at one year.
RESULTS:
HAQ-DI progression was observed in 18% of the patients. The multiple logistic regression analysis revealed the independent variables associated with HAQ-DI progression were: DAS28-ESR >5.1 at baseline (odds ratio [OR] 0.31, 95% con dence interval [CI] 0.13–0.74, p=0.0083); HAQ-DI score at baseline <0.5 (OR 2.27, 95% CI 1.22–4.26, p=0.0102); and achievement of low disease activity at 12 weeks (OR 0.42, 95% CI 0.21–0.82, p=0.0112).
CONCLUSIONS:
Our data suggest that maintaining clinical improvement according to T2T and initiating the treatment at an early stage are important for functional improvement after one year and that patients with low baseline HAQ scores have a higher risk of HAQ disability progression.

Rheumatology Article