Tags

Type your tag names separated by a space and hit enter

Efficient management of rheumatoid arthritis significantly reduces long-term functional disability.
Ann Rheum Dis. 2008 Aug; 67(8):1153-8.AR

Abstract

OBJECTIVES

The aim of this study was to examine the effect of efficient management of rheumatoid arthritis (RA) in relation to disability levels in a large cohort of patients with RA over a period of 3 years.

METHODS

We studied 2775 patients with RA who had continuous enrolment for at least 3 years from 7511 patients with RA enrolled in an observational cohort study (Institute of Rheumatology, Rheumatoid Arthritis (IORRA)) from October 2000 to April 2005. The 28-joint Disease Activity Scores (DAS28) were calculated at 6 month intervals for all the patients and a value <2.6 was considered as a tight control. We have set up a new variable for each patient, "Avg-Dscore", based on the transition of each patient's DAS28 value, taking the threshold level of 2.6 into consideration. The "Avg-DAS28" is the average of DAS28 values over all the phases. Functional disability status was assessed by J-HAQ, the validated Japanese version of the Health Assessment Questionnaire (HAQ). The relationship of "Avg-Dscore" and "Avg-DAS28" with the functional disability level was determined using Spearman correlation coefficients and multiple linear regression models.

RESULTS

The baseline features of these 2775 patients were: female 83.7%, mean age 56.8 years, mean RA duration 9.5 years, mean initial DAS28 4.0, mean initial J-HAQ score 0.79, and mean final J-HAQ score 0.86. There was a statistically significant correlation between "Avg-DAS28" and final J-HAQ score (r = 0.57, p<0.001), indicating that tighter disease control has significant association with lower disability levels. A similar relationship was observed between "Avg-Dscore" and final J-HAQ score (r = 0.47, p<0.001). Multiple linear regression analysis, after adjusting for all the covariates, revealed that "Avg-Dscore" and "Avg-DAS28" were the most significant factors contributing to final J-HAQ score, and confirmed the strong relationship between disease activity and functional disability.

CONCLUSIONS

In patients with RA efficient disease management, by maintaining the DAS28 values at a level under 2.6, has significant association with improving functional capability. The threshold DAS28 level of 2.6 may be useful in developing targeted treatment guidelines for patients with RA.

Authors+Show Affiliations

Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan. e-tanaka@tkg.att.ne.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17971459

Citation

Tanaka, E, et al. "Efficient Management of Rheumatoid Arthritis Significantly Reduces Long-term Functional Disability." Annals of the Rheumatic Diseases, vol. 67, no. 8, 2008, pp. 1153-8.
Tanaka E, Mannalithara A, Inoue E, et al. Efficient management of rheumatoid arthritis significantly reduces long-term functional disability. Ann Rheum Dis. 2008;67(8):1153-8.
Tanaka, E., Mannalithara, A., Inoue, E., Hara, M., Tomatsu, T., Kamatani, N., Singh, G., & Yamanaka, H. (2008). Efficient management of rheumatoid arthritis significantly reduces long-term functional disability. Annals of the Rheumatic Diseases, 67(8), 1153-8.
Tanaka E, et al. Efficient Management of Rheumatoid Arthritis Significantly Reduces Long-term Functional Disability. Ann Rheum Dis. 2008;67(8):1153-8. PubMed PMID: 17971459.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficient management of rheumatoid arthritis significantly reduces long-term functional disability. AU - Tanaka,E, AU - Mannalithara,A, AU - Inoue,E, AU - Hara,M, AU - Tomatsu,T, AU - Kamatani,N, AU - Singh,G, AU - Yamanaka,H, Y1 - 2007/10/30/ PY - 2007/11/1/pubmed PY - 2008/8/12/medline PY - 2007/11/1/entrez SP - 1153 EP - 8 JF - Annals of the rheumatic diseases JO - Ann Rheum Dis VL - 67 IS - 8 N2 - OBJECTIVES: The aim of this study was to examine the effect of efficient management of rheumatoid arthritis (RA) in relation to disability levels in a large cohort of patients with RA over a period of 3 years. METHODS: We studied 2775 patients with RA who had continuous enrolment for at least 3 years from 7511 patients with RA enrolled in an observational cohort study (Institute of Rheumatology, Rheumatoid Arthritis (IORRA)) from October 2000 to April 2005. The 28-joint Disease Activity Scores (DAS28) were calculated at 6 month intervals for all the patients and a value <2.6 was considered as a tight control. We have set up a new variable for each patient, "Avg-Dscore", based on the transition of each patient's DAS28 value, taking the threshold level of 2.6 into consideration. The "Avg-DAS28" is the average of DAS28 values over all the phases. Functional disability status was assessed by J-HAQ, the validated Japanese version of the Health Assessment Questionnaire (HAQ). The relationship of "Avg-Dscore" and "Avg-DAS28" with the functional disability level was determined using Spearman correlation coefficients and multiple linear regression models. RESULTS: The baseline features of these 2775 patients were: female 83.7%, mean age 56.8 years, mean RA duration 9.5 years, mean initial DAS28 4.0, mean initial J-HAQ score 0.79, and mean final J-HAQ score 0.86. There was a statistically significant correlation between "Avg-DAS28" and final J-HAQ score (r = 0.57, p<0.001), indicating that tighter disease control has significant association with lower disability levels. A similar relationship was observed between "Avg-Dscore" and final J-HAQ score (r = 0.47, p<0.001). Multiple linear regression analysis, after adjusting for all the covariates, revealed that "Avg-Dscore" and "Avg-DAS28" were the most significant factors contributing to final J-HAQ score, and confirmed the strong relationship between disease activity and functional disability. CONCLUSIONS: In patients with RA efficient disease management, by maintaining the DAS28 values at a level under 2.6, has significant association with improving functional capability. The threshold DAS28 level of 2.6 may be useful in developing targeted treatment guidelines for patients with RA. SN - 1468-2060 UR - https://www.unboundmedicine.com/medline/citation/17971459/Efficient_management_of_rheumatoid_arthritis_significantly_reduces_long_term_functional_disability_ L2 - https://ard.bmj.com/lookup/pmidlookup?view=long&amp;pmid=17971459 DB - PRIME DP - Unbound Medicine ER -