Background Rheumatoid arthritis (RA) has a substantial negative impact on patients' (pts) lives and is marked by pain and reduced mobility. In addition to RA articular manifestations, RA is often associated with important extra-articular manifestations, including anxiety and depression.1
Objectives To describe pt self-reporting of anxiety and depression in pts with RA and to better characterize the association of anxiety/depression with disease activity, disability, and satisfaction with current treatment.
Methods Descriptive analyses and multivariate linear and logistic regression analyses were performed using mood disorder data from the EU5 and US Adelphi RA Disease Specific Program. Presence of anxiety and depression was reported by pts that completed the EQ-5D anxiety/depression domain in the Patient Self Completion form. Multivariate models were run, controlling for pt age, gender, body mass index, and current disease severity, for each of the following measures: WPAI, HAQ-DI, DAS28 (ESR), and pt satisfaction with current treatment. WPAI, HAQ-DI, and DAS28 (ESR) data were evaluated using linear models, and pt-reported satisfaction were evaluated using logistic regression models.
Results For the sample of pts included in the analysis (n=1,015), 38.4% of pts reported moderate or extreme anxiety/depression as their current health state. Pts with self-reported moderate (n=349) or extreme (n=41) anxiety/depression had greater work impairment, higher scores on the HAQ-DI, higher scores on the DAS28 (ESR), and a higher likelihood of being dissatisfied with their current treatment than those without stated depressed mood or anxiety. (n=625; Table). In multivariate analyses, significant differences were observed between the presence of pt-reported moderate anxiety/depression and higher WPAI scores (P<0.001), higher HAQ-DI scores (P<0.001), and lower pt-reported satisfaction with current treatment (P<0.001); significant differences were also observed between the presence of pt-reported extreme anxiety/depression and poorer results on the DAS28 (ESR) (P=0.004), HAQ-DI (P<0.001), and pt-reported satisfaction with current treatment (P=0.001), all compared to pts without anxiety or depression.
Conclusions Anxiety and depression represent a significant burden for pts with RA. In this analysis, pt-reported mood disorders were independently associated with work impairment, disability, pt satisfaction with current treatment, and clinical disease activity. These findings highlight the multi-dimensional impact of anxiety and depression as a key extra-articular manifestation of RA. Further research on optimal management of this key unmet medical need is warranted.
Isik A, et al. Clin Rheumatol. 2007;26(6):872–878.
Disclosure of Interest S. Peterson Shareholder of: Janssen, Employee of: Janssen, N. Li Employee of: Janssen, S. Blackburn Employee of: Adelphi Real World, D. Kielar Shareholder of: Janssen, Employee of: Janssen