THU0169 Relationship of frailty and disease activity in patients with rheumatoid arthritis: data from the chikara study

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 303
• Main Authors: Tada, M., Yamada, Y., Mandai, K., Hidaka, N.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Cognition; Erythrocyte sedimentation rate; Frailty; Geriatrics; Health risk assessment; Leg; Matrix metalloproteinase; Metalloproteinase; Morbidity; Multivariate analysis; Phenotypes; Remission; Rheumatoid arthritis; Sarcopenia; Skeletal muscle; Stromelysin 1
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.1807

BackgroundFrailty is defined as degradation of physical and cognition function in elderly adult1. The characteristics of frailty include not only physical problems as co-morbidity and disability, but also mental and social problems. It is unclear of relationship between frailty and disease activity of patients with rheumatoid arthritis (RA).ObjectivesWe investigated the relative factors about frailty in patients with RA from a prospective observational study.Methods95 from 100 patients entered the CHIKARA study (Correlation researcH of sarcopenIa, sKeletal muscle and disease Activity in Rheumatoid Arthritis) were investigated by frailty check list (maximal score is 25). According to reported article, frailty was defined from 8 to 25 and pre-frailty was from 4 to 7, and normal was from 0 to 3. We investigated relationship of disease activity in frailty, pre-frailty and normal groups, and analysed the relative factors for frailty.ResultsThe prevalence of frailty, pre-frailty, and normal was 19%, 39% and 42%, respectively. The character of groups indicated at table 1. Frailty group was the oldest of three groups. Disease activity sore 28 erythrocyte sedimentation rate (DAS28ESR) and matrix metalloproteinase 3 (MMP3) of frailty group was higher than those of pre-frailty and normal groups. Whereas, modified health assessment questionnaire (mHAQ) of frailty group was lower than those of pre-frailty and normal groups. Normal was 66.6% and frailty was 6.7% in remission patients. However, Normal was 13.3% and frailty was 46.7% in moderate and high disease activity patients (figure 1). The prevalence of frailty was increased with disease activity. The relative factors for frailty were age, locomotive syndrome, DAS28ESR, mHAQ, and Steinbroker class, positively and leg muscle score and grip strength, negatively by univariate analysis. Steinbroker class (odds ratio: 3.25 95% CI: 1.11–9.51, p=0.031) and mHAQ (odds ratio: 1.29, 95% CI: 1.13–1.46, p<0.001) were independent relative factors by multivariate analysis.Abstract THU0169 – Table 1The character of frailty, pre-frailty, and normal in patients with RAFrailtyPre-frailtyNormalP value Age, years72.5±10.368.6±11.360.7±16.40.01Leg muscle score84.9±5.986.2±6.493.2±9.7<0.001Grip, kg12.6±6.917.7±7.118.1±6.20.013Locomotive 5 score11.1±5.86.4±4.92.6±4.0<0.001MMP3, ng/dl143.7±122.095.9±66.088.6±52.00.033DAS28ESR3.62±0.973.27±1.022.83±0.960.015mHAQ0.9±0.70. 4±0.20.1±0.1<0.001Sarcopenia,%3941180.063ConclusionsIt was revealed that frailty involved disease activity and physical function in patients with RA. Control of disease activity is important to prevent not only disease progression, but also frailty.Reference[1] Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci2001;56:M146–56.Disclosure of InterestNone declared