Background Evidence suggests rheumatoid arthritis (RA) confers an increased risk of psychological morbidity, particularly anxiety and depression, which may affect the subsequent management and treatment adherence.1,2 Few studies have studied psychological factors over time in RA patients.3
Objectives We aimed to evaluate the prevalence of anxiety and depression in RA patients following rituximab treatment initiation and prolongation.
Methods Biologics-naïve RA patients were followed up for 27 months after commencing and continuing rituximab therapy (1, 2, 3 standard courses). Anxiety and depression, and health-related quality of life (HRQoL) were assessed at baseline, 3, 15 and 27 months using the Hospital Anxiety and Depression Scale (HADS) and the Short Form (SF-36 v.1) Health Survey questionnaire, respectively.
Results 86 patients [mean (SD) age 49.2 (9.3) years, 76 women; median (IQR) DAS28 5.64 (3.92–8.42); median (IQR) HAQ 1.85 (1.0–3.5)] were recruited. Median anxiety and depression scores decreased significantly between baseline and 3 months (p<0.001) and remained decreased over the 27-month period. The prevalence of depression cases decreased twice from baseline to 27 months (66.3% to 30.0%), as did the prevalence of anxiety (79.1% to 40.0%). Patients reported poor baseline HRQoL. SF-36 v.1 domain scores substantially raised after 15 months.
Conclusions Anxiety and depression levels decrease significantly following commencement and continuity of rituximab. B cell-directed therapy for patients with RA helps achieve remission of both anxiety and depression, and improves health-related quality of life.
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Overman CL, Bossema ER, van Middendorp H et al. The prospective association between psychological distress and disease activity in rheumatoid arthritis: a multilevel regression analysis. Ann Rheum Dis 2012;71:192–197.
Disclosure of Interest: None Declared