Background The significance of early diagnosis and early therapy initiation in patients with RA is tremendous. ADAPTHERA is a state wide rheumatology network based in Rhineland-Palatinate, Germany. ADAPTHERA aims to improve RA prognosis and quality of patients` life by reducing the time-to-RA-diagnosis. While there have been a lot of studies regarding quality of life in patients with established RA1,2, adequate data concerning very early rheumatoid arthritis (VERA) (disease duration <3 months) are lacking.
Objectives To study quality of life in VERA patients and to investigate its associations with various RA associated clinical and laboratory parameters.
Methods In a two center subgroup analysis from the ADAPTHERA cohort, we studied quality of life indexes such as Hannover Functional Ability Questionnaire (HFAQ), Health Assessment Questionnaire (HAQ), EuroQol-5D-3L (EQ-5D-3L), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) and World Health Organisation-5 Well Being Index (WHO-5) in patients with VERA. Moreover, we examined the statistical relationship of these indexes with various clinical and laboratory RA associated parameters such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF)-/ cyclic citrullinated peptide antibodies (anti-CCP)-status and Disease Activity Score 28 (DAS28) as well as its components [counts of tender and swollen joints, Visual Analogue Scale (VAS)].
Results 74 Patients (50 females, 24 males) with a median age of 62 years (IQR 49, 71) were identified as VERA patients. 36 of them were anti-CCP positive and 34 RF positive. Median scores for HFAQ, HAQ, EQ-5D-3L, FACIT-Fatigue, and WHO-5 were 75.5 (IQR 61, 92.5), 0.75 (IQR 0.26, 1.25), 0.89 (IQR 0.79, 0.89), 40 (IQR 32, 46) and 60 (IQR 32, 76) accordingly. The results of the statistical associations between these scores and RA associated parameters are seen in Table 1.
Conclusions The quality of life indexes HFAQ, HAQ, EQ-5D-3L and WHO-5 are associated with two or more markers of disease activity in patients with VERA. Therefore, improvement of patients' quality of life is linked to the achievement of disease remission. In contrast, the FACIT-fatigue index seems to be solely associated with arthritis pain intensity. Thus, improvement of fatigue requires an effective pain management strategy.
Gossec L et al., RMD Open. 2015 Apr 2;1(1):e000019.
Her M et al., Curr Opin Rheumatol, 2012 May;24(3):327–34.
Disclosure of Interest None declared
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