Background Treat-to-Target (T2T) recommendation aims at maximizing long-term quality of life (QOL) of rheumatoid arthritis (RA) patients by controlling symptoms, prohibiting joint destruction, normalizing physical functions and enabling patients’ social participation.1
We have DAS28/SDAI/CDAI and Boolean-based approach for assessing symptom control, modified total Sharp score and Genant-modified Sharp score for joint assessment, and HAQ-Disability Index for assessing physical functional ability, but no report has been made for assessing social activity level.
Objectives Our study is to explore social activity levels of RA patients using Arthritis Impact Measurement Scales version 2 (AIMS-2), scales for assessing QOL, and to analyze factors that would effect social participation.
Methods We conducted an AIMS-2 survey in RA patients receiving treatment with biologics at our outpatient clinic
Results Enrollment period was from May to August, 2011. A total of 203 RA patients had consented to be enrolled in this study; among them, 93 subjects were treated with Etancercept, 47 subjects were treated with Infliximab, 20 subjects were treated with Adalimumab, 28 subjects were treated with Tocilizumab, and 15 subjects were treated with Abatacept. We analyzed the four most relevant scales out of twelve listed under AIM-2, “household tasks”, “social activities”, “support from family”, and “work”. We categorized data based on delivery methods of biologic treatment, age, and disease duration and compared each group by using t-test.
We subtracted two delivery method groups, infusion group (n=90) and self injection group (n=56), from the entire cohort and compared these two groups. Self injection group marked better scores in all four scales, and there were statistically significant differences in “household tasks” and “work” (p<0.03 and p<0.001, respectively). Since the mean age of infusion group was older than the self-injection group (60.4 vs 53.5, p<0.001), we further analyzed these groups by limiting patients to those older than sixty years old (n=50 in infusion group and n=20 in self injection group). No significant differences were found but slightly better trend in “social activities” seen in infusion group.
In comparing different age groups (age under 60 years old n=79, over 60 years old n=124), under 60 years old group scored better in “household tasks”, “social activities”, “work”, especially “household tasks” with statistically significant difference (p<0.001).
No statistical differences were seen in groups divided by disease duration (five years n=140, the rest of the patients were not included as their disease durations were unknown). They both marked same scores in “household tasks”, and shorter disease duration group trended better in the rest of the three scales.
Conclusions Self injection group scored better than infusion group in all scales. Age could be one reason for this positive result for self injection, but this still could be a method to maximize social participation. RA patients younger than fifty years old and patients with shorter disease duration seem to be better factors in driving patients to social participation
Smolen JS et al. Ann Rheum Dis 2010 69; 631-637
Disclosure of Interest None Declared
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