Background Rheumatoid arthritis (RA) is related to reduced health related quality of life (HRQL) despite early instituted disease modifying anti rheumatic drugs (DMARD:s) during the 1990's (1).
Objectives To analyse differences regarding HRQL in women and men that were diagnosed during the 2000's compared to patients diagnosed ten years earlier before the introduction of biological agents.
Methods The 276 patients (69% women) still participating at the three years follow up in the “pre biological” early RA-cohort (TIRA-1, included 1996-1998) constitutes the study group together with the corresponding 373 patients (67% women) in the second cohort (TIRA-2, 2005-2008) included after introduction of biological agents. Disease activity score (DAS 28) and DMARD:s were registered and HRQL was reported in Short Form 36 (SF-36, score 0 to 100) in the subscales Physical Functioning (PF), Role Physical (RP), Bodily Pain (BP), General Health (GH), Vitality (VT), Social Functioning (SF), Role Emotional (RE) and Mental Health (MH) at inclusion (Y0) and after one year (Y1), 2 (Y2), and 3 years (Y3). The study protocol was approved by the local ethics committee in Linköping, Sweden.
The cohorts showed no significant differences (P≤0,001) in DAS28 at inclusion but more patients were prescribed DMARD:s, including biological agents, in TIRA2 at all occasions. DAS did not differ between sexes in TIRA-1, but men had lower DAS than women at all occasions in TIRA-2.
Results Differences between cohorts: for both sexes there were no differences in SF-36 at inclusion between cohorts, but at the follow-ups most scales showed higher HRQL in women and men in TIRA-2 (T1) compared to in TIRA-1 (T1) except for MH and SF which did not differ between cohorts. The mean scores at Y3 for women in T1/T2 were; PF 58/69; RP 52/62; BP 52/62; GH 51/63; VT 52/57; SF 79/81; RE 69/7; MH 74/76 and the corresponding for men were PF 66/75; RP 53/64; BP 52/69; GH 55/63; VT 58/66; SF 84/91; RE75/80; MH 79/84.
Differences within cohorts: men had higher HRQL than women at some occasions in TIRA-1 (T1) (Y0 =MH; Y1=GH, MH, SF; Y3=MH, PF) and in some occasions in TIRA-2 (T1) (Y0=PF; Y1=BP, PF, VT; Y2=BP, MH, PF, VT; Y3=BP, MH, PF, SF, VT).
Course: from Y0 to the follow ups, HRQL increased in all scales in both cohorts in both sexes except for GH in TIRA 2 that was stable over time.
Conclusions More DMARD:s is prescribed and HRQL has increased in today's patients compared to 10 years earlier, most evident for physical aspects. Our results indicate continuing needs for multi professional interventions, especially for women, in addition to DMARD:s.
Thyberg I, Skogh T, Hass UA, Gerdle B. J Rehabil Med. Recent-onset rheumatoid arthritis: a 1-year observational study of correlations between health-related quality of life and clinical/laboratory data. J Rehabil Med. 2005;37:159-65
Disclosure of Interest None declared