Background Approximately 15% of RA patients also suffer from depression, with an odds ratio of 1.42 (95% CI 1.3 - 1.5) compared with healthy people. A previous study reported that biological agents can improve the depressed state associated with RA. Although previous studies have been cross-sectional, there were no reports that analyzed factors that led to depression remission.
Objectives To examine the relationship between baseline factors and depression remission after six-month biologic agent treatment in rheumatoid arthritis (RA) patients.
Methods The subjects were 384 RA patients treated with biologic agents. The following patient's characteristics were investigated: age, gender, number of previous drugs, disease duration, type of biologic agents, baseline steroid dosage, methotrexate dosage and serum matrix metalloproteinase-3 (MMP-3) levels. For evaluation, we used the Simplified Disease Activity Index for RA disease activity; the Health Assessment Questionnaire Disability Index (HAQ-DI) score for activities of daily living; the Short Form-36 for nonspecific health-related quality of life; and Hamilton Depression Rating Scale (HAM-D) scores for depression status. Depression remission was defined by HAM-D≦7 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.
Results We included 152 patients in the analysis. Two hundred thirty-two patients were excluded due to primary and secondary failure, complications, loss to 6-month follow-up, incomplete data, etc. Compared with a group of RA patients with depression remission (n=124), a group of patients with no depression remission (n=28) had a younger age (p=0.000), female sex (p=0.039), lower serum MMP-3 levels (p=0.021), lower HAQ-DI (p=0.018), lower HAM-D score (p=0.000), and higher Role/Social component summary score of the SF-36 (p=0.009) by univariate analyses. The binominal logistic analyses findings were as follows: younger age (p=0.0045, odd ratio: 0.94, 95% CI: 0.8–0.98), female sex (p=0.021, odd ratio: 0.21, 95% CI: 0.054–0.79), and lower HAM-D scores (p=0.0073, odd ratio: 0.85, 95% CI: 0.76–0.96).
Conclusions It was suggested that RA patients who are female, younger in age and have lower depression scores at baseline are more likely to achieve depression remission status with the biologic treatment.
Acknowledgements All Showa University in Rheumatoid Arthritis (ASHURA) group
Disclosure of Interest Y. Miwa Grant/research support from: Astellas Pharma Inc., Mitsubishi Tanabe Pharma Corporation, Pfizer Japan Inc., Chugai Pharmaceutical Co., Ltd., and Eizai Co., Ltd., Ono Pharma Co., Ltd., N. Yajima: None declared, T. Isozaki: None declared, R. Takahashi: None declared, Y. Miura: None declared, Y. Ikari: None declared, M. Hatano: None declared, T. Hayashi: None declared, T. Kasama Grant/research support from: Mitsubishi Tanabe Pharma Corporation and Pfizer Japan Inc., K. Sanada: None declared