SAT0094 Physical function and health related quality of life in early rheumatoid arthritis patients who achieved only low disease activitycompared with remission

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 909
• Main Authors: Lam, H.M., Wan, M.C., Tam, L.S.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Health risk assessment; Image processing; Pain; Patients; Prednisolone; Quality of life; Remission; Rheumatoid arthritis
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.2839

BackgroundCurrent treatment target for rheumatoid arthritis (RA) aims at reaching sustained remission or Low Disease Activity (LDA). It is unclear whether achieving clinical remission is necessary or achieving stable LDA is already sufficient to maintain physical function and Health Related Quality of Life (HRQoL) in patients with early RA.ObjectivesTo compare physical function and health related quality of life in early RA patients who achieved sustained remission and those who achieved only sustained LDA.MethodsEarly RA patients with symptom onset <2 years were recruited. Disease activity over time was determined by the cumulative average of Disease Activity Score 28 (caDAS28) and Simple Disease Activity Index (caSDAI) measured at month 3, 6, 9 and 12. Physical function was measured by the Health Assessment Questionnaire Disability Index (HAQ-DI). HRQoL was assessed by the Physical Component Scale (PCS) and Mental Component Scale (MCS) of the 36-Item Short Form Survey (SF-36) and the Euro Quality of Life Five Dimensions Questionnaire (EQ-5D).ResultsA total of 308 (53±13 years old, 80 [26.0%] male) patients completed one year follow up (table 1). 132 (42.9%) and 87 (28.2%) patients achieved caDAS28 remission and caDAS28 LDA while 48 (15.6%) and 156 (50.6%) patients achieved caSDAI remission and caSDAI LDA. Patients who achieved caDAS28 remission have better SF-36 PCS, HAQ-DI and EQ5D at year 1 than patients who achieved only caDAS28 LDA or remained active after adjusting for other potential confounders at baseline with multivariable regression analysis (Image 1). However, SF-36 PCS, HAQ-DI were not different between caSDAI remission and caSDAI LDA after adjustment for confounders.Abstract SAT0094 – Table 1n=308 BaselineMonth 12p value Symptom duration, months9.76±8.29---VAS pain, 0–104.61±2.322.41±2.08<0.001VAS patient global, 0–1051.95±23.3225.22±21.47<0.001VAS physician global, 0–1050.64±26.4417.77±17.99<0.001Tender joint count, 0–287.36±5.951.99±2.98<0.001Swollen joint count, 0–284.35±3.870.86±1.72<0.001ESR, mins57.08±34.1933.94±24.35<0.001CRP, mg/L21.84±31.656.29±11.07<0.001SDAI24.14±13.227.78±7.25<0.001DAS28 CRP4.46±1.252.52±0.98<0.001csDMARDs, n (%)134 (43.8%)282 (92.2%)<0.001bDMARDs, n (%)0 (0%)11 (4.9%)<0.001Prednisolone, n (%)104 (34.1%)97 (31.8%)0.649NSAID, n (%)207 (69.4%)143 (48%)<0.001PCS, (0–100)27.84±12.9239.81±12.65<0.001MCS, (0–100)43.46±10.6048.12±11.87<0.001HAQ-DI, (0–3)0.82±0.630.33±0.43<0.001EQ5D, (0–1)0.67±0.150.79±0.16<0.001ConclusionsPatients who achieved sustained caDAS28 LDA had significantly worse physical function and HRQoL than patients who achieved caDAS28 remission.Disclosure of InterestNone declared