Background It is known that rheumatoid arthritis (RA) is comorbid with various diseases and especially concomitant depression is common with a high prevalence of approximately 20%. Even if RA disease activity is controlled, patients with persistent depression result in decreased activity of daily life (ADL) and quality of life (QOL).
Objectives To study predictive factors for no depression status after using biologic agents for 6 months.
Methods The study was 333 RA patients treated with biologic agents. The following patient's characteristics were investigated: age, gender, the number of previous drugs, disease duration, the type of biologic agents, baseline steroid dosage, MTX dosage, serum rheumatoid factor (RF), serum matrix metalloproteinase-3 (MMP-3), anti-cyclic citrullinated peptide antibody (anti-CCP antibody), tumor necrosis factor (TNF)-α, and interleukin (IL)-6. For evaluation we used Simplified Disease Activity Index (SDAI) for RA disease activity, Health Assessment Questionnaire (HAQ) for ADL, Short Form (SF)-36 for QOL, and Hamilton Depression Rating Scale (HAM-D) or Self-rating depression scale (SDS) for depression status. No depression was defined by HAM-D≦7 or SDS≦39 after 6 months of treatment. The subjects were divided into two groups according to the presence or absence of depression, and a retrospective study was performed. We excluded 101 patients due to loss to 6-month follow-up and 39 patients due to incomplete data; therefore, we included 193 patients in the analysis.
Results Compared with a group of RA patients with depression (n=130), a group of patients without depression (n=63) had younger age (52.7± 14.8 vs. 59.8±14.3, p=0.002), more males (p=0.046), lower baseline steroid dosage (3.2±3.1mg vs. 5.0±4.4mg, p=0.002), lower SDAI (22.9±12.8 vs. 29.5±15.2, p=0.002), lower HAQ (0.43 ±0.47 vs. 0.75±0.62, p<0.001), higher SF-36 (p<0.05 in all categories), lower SDS (38.2±8.5 vs. 46.7±9.6, p<0.001), and lower HAM-D (5.0±4.0 vs. 9.3±6.0, p<0.001) were detected based on univariate analysis. On the other hand, younger age (p=0.0352), more males (p=0.0048), lower baseline steroid dosage (p=0.0459), lower titer of serum RF (p=0.0114), lower HAQ (p=0.0485) and lower “pain (p=0.0222)”, “general health perception (p=0.0364)” and “social functioning (p=0.0078)” item of the SF-36 were detected based on logistic regression analysis.
Conclusions It was suggested that RA patients with more male, lower disease activity, lower dosage of steroid, younger age, and higher ADL and QOL at baseline are more likely to achieve no depression status with biologic treatment.
Disclosure of Interest Y. Miwa Grant/research support from: Tanabemitsubishi, Chugai, phizer, Ono, M. Hatano: None declared, A. Nishimi: None declared, S. Nishimi: None declared, T. Hayashi: None declared, R. Yanai: None declared, H. Furuya: None declared, M. Umemura: None declared, T. Kasama: None declared, M. Hosaka: None declared, K. Sanada: None declared