Joint overuse in rheumatoid arthritis patients

• Published in: Clinical Rheumatology and Related Research Vol. 32; no. 3; pp. 201 - 209
• Main Authors: Abe, Asami, Ito, Satoshi, Ishikawa, Hajime, Murasawa, Akira, Kobayashi, Daisuke, Otani, Hiroshi, Narita, Ichiei, Amao, Sachimi, Nakazono, Kiyoshi, Hasegawa, Eriko
• Format: Journal Article
• Language: English
• Published: The Japanese Society for Clinical Rheumatology and Related Research 2020; 一般社団法人 日本臨床リウマチ学会
• Subjects: biological disease-modifying anti-rheumatic drugs; joint overuse; patient education; rehabilitation; rheumatoid arthritis
• ISSN: 0914-8760; 2189-0595
• DOI: 10.14961/cra.32.201

Background: The development of drug therapies for rheumatoid arthritis（RA）, and control of synovitis has now become easier. However, once patients are relieved of pain, they become physically more active and sometimes overuse their joints. Here we analyzed the clinical characteristics of such patients who had overused their joints.Methods: In-depth history taking about joint overuse and physical examinations were performed prospectively for 3148 consecutive patients with RA who visited our outpatient department between August 2016 and October 2016. Patients who had joint pain and swelling of the strained joints, were diagnosed as having joint overuse. Their clinical features and laboratory data before they developed joint overuse were collected from their medical records. As comparative controls, we selected 123 age- and sex-matched contemporary patients with RA who had no joint overuse from among 3148 patients.Results: Forty-one patients（10 men and 31 women）with a median age of 62.0 years were diagnosed as having joint overuse. Logistic regression analysis revealed that treatment with biological disease-modifying antirheumatic drugs（bDMARDs; odds ratio [OR], 3.10; 95% confidence interval [CI], 1.24 - 7.76）, low health assessment questionnaire disability index（HAQ-DI; OR, 0.27 95% CI, 0.09-0.80）, and Steinbrocker stage III or IV（OR, 5.90; 95% CI, 2.28-15.2）were significantly associated with the development of joint overuse.Conclusion: When patients with advanced RA have low HAQ-DI using bDMARDs, they are at risk of joint overuse. Appropriate education would be important for such patients to prevent such overuse.