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SAT0121 Comorbities and disease activity are relevant for functional disability in rheumatoid arthritis
  1. N Andrade1,
  2. AM Kakehasi2,
  3. C Machado2,
  4. K Gomes3,
  5. MF Guimarães2,
  6. S Krampe1,
  7. C Rodrigues3,
  8. C Brenol1
  1. 1Federal University of Rio Grande do Sul, Porto Alegre
  2. 2Universidade Federal de Minas Gerais, Belo Horizonte
  3. 3University of Fortaleza, Fortaleza, Brazil

Abstract

Background Health status in rheumatoid arthritis (RA), as measured by Health Assessment Questionnaire - Disability Index (HAQ-DI), has been established as a relevant quantitative measure to assess and monitor the disease (1). Current RA therapy has shown improvement in patient-reported outcomes, but more data on specific factors influencing health status are needed (2).

Objectives To assess the relationship between functional disability and clinical factors in patients with RA, using the HAQ score.

Methods Cross-sectional study in patients with RA according to the ACR classification criteria from three Brazilian University Hospitals. Demographic and comprehensive clinical data, including components of metabolic profile were collected. Blood pressure, weight and height were determined in the assessment visit and recent laboratory data were assessed from medical records. Disease activity was evaluated by the Disease Activity Score in 28 joints (DAS28) and functional disability was assessed by the HAQ-DI, considering an index>0.5 as disability. All analyses were performed using Stata for MAC 12.0 software. Variables that achieved a p–value<0.3 in the univariate analysis were considered as candidates to take part of a multivariate binomial logistic model, and in this model, variables were considered as statistically significant at the 0.05 significance level (3).

Results 453 patients were included, 380 (83.9%) women, mean age 55.7 (±12) years, 356 (79.1%) Caucasian, and mean disease duration of 13.3 (±9) years. Methotrexate were used by 73.5% of the sample. Mean DAS28 was 3.9 (±1.4), mean HAQ score was 1.11 (±0.77), and 23.9% of the patients had HAQ score>0.5. Dyslipidemia, diabetes mellitus (DM), high blood pressure (HBP) and family history of premature cardiovascular disease occurred in 28.6%, 12.8%, 51% and 21.4% of the patients, respectively. Mean body mass index (BMI) was 27.1 (±4.9) kg/m2. In multivariate analysis age, DAS28, tobacco use, and diabetes mellitus were independently associated with HAQ>0.5 (TABLE 1).

Table 1.

Association between clinical parameters, disease activity, and functional disability (HAQ >0.5)

Conclusions Our results depicted that distinct factors could reflect in the functional status response in RA patients. This is relevant since it may influence the clinicaly important difference when evaluating the HAQ response in populations with diverse cultural features and different comorbidities prevalence.

References

  1. Fries JF, Spitz P, Kraines RG, Holamn HR: Measurement of patient outcome in arthritis. Arthritis Rheum 1980; 23: 137–45.

  2. Pincus T. Are Patient Questionnaire Scores as “Scientific” as Laboratory Tests for Rheumatology Clinical Care? Bull NYU Hosp Jt Dis. 2010;68(2):130–139.

  3. Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code for Biology and Medicine. 2008;3:17. doi:10.1186/1751–0473–3-17.

References

Disclosure of Interest None declared

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