Health Assessment Questionnaire at One Year Predicts All‐Cause Mortality in Patients With Early Rheumatoid Arthritis

Abstract

Objective Higher self‐reported disability (high Health Assessment Questionnaire [HAQ] score) has been associated with hospitalizations and mortality in established rheumatoid arthritis (RA), but associations in early RA are unknown. Methods Patients with early RA (symptom duration <1 year) enrolled in the Canadian Early Arthritis Cohort who initiated disease‐modifying antirheumatic drugs and had completed HAQ data at baseline and 1 year were included in the study. Discrete‐time proportional hazards models were used to estimate crude and multi‐adjusted associations of baseline HAQ and HAQ at 1 year with all‐cause mortality in each year of follow‐up. Results A total of 1,724 patients with early RA were included. The mean age was 55 years, and 72% were women. Over 10 years, 62 deaths (3.6%) were recorded. Deceased patients had higher HAQ scores at baseline (mean ± SD 1.2 ± 0.7) and at 1 year (0.9 ± 0.7) than living patients (1.0 ± 0.7 and 0.5 ± 0.6, respectively; P < 0.001). Disease Activity Score in 28 joints (DAS28) was higher in deceased versus living patients at baseline (mean ± SD 5.4 ± 1.3 versus 4.9 ± 1.4) and at 1 year (mean ± SD 3.6 ± 1.4 versus 2.8 ± 1.4) (P < 0.001). Older age, male sex, lower education level, smoking, more comorbidities, higher baseline DAS28, and glucocorticoid use were associated with mortality. Contrary to HAQ score at baseline, the association between all‐cause mortality and HAQ score at 1 year remained significant even after adjustment for confounders. For baseline HAQ score, the unadjusted hazard ratio (HR) was 1.46 (95% confidence interval [95% CI] 1.02–2.09), and the adjusted HR was 1.25 (95% CI 0.81–1.94). For HAQ score at 1 year, the unadjusted HR was 2.58 (95% CI 1.78–3.72), and the adjusted HR was 1.75 (95% CI 1.10–2.77). Conclusion Our findings indicate that higher HAQ score and DAS28 at 1 year are significantly associated with all‐cause mortality in a large early RA cohort.

Effectiveness and safety of aerobic exercise for rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials

“…The Health Assessment Questionnaire disability index (HAQ-DI) is a popular index for measuring the funcof joints by the patients' multidimensional ability to perform activities of daily living [37]. With good reliability and validity, the HAQ-DI helps to detect functional changes, monitor the severity of disease, and predict all-cause mortality in RA patients [46][47][48]. This study's analysis result shows that aerobic exercise can effectively reduce the HAQ-DI score, which is consistent with the analysis result of Bailet [49], indicating that aerobic exercise is of great significance for improving functional ability.…”

Examining the Relationship Between Rheumatoid Arthritis, Multimorbidity, and Adverse Health‐Related Outcomes: A Systematic Review

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Study of Nepheroblastoma Overexpressed Protein (NOV/CCN3) as a Biomarker in Serum of Iraqi Patients with Rheumatoid Arthritis

“…The mean ±SE of Diastole in patient's and control were [(12.60 ±0.15) (12.03 ±0.07)] respectively, the result indicates a non-significant change between two groups in the Diastole (P>0.05) as shown in Table (3).…”

“…Because it can affect numerous organ systems, such as the cardiovascular, pulmonary, ophthalmic, and cutaneous systems, as well as the hematologic system, the risk of multiple related problems is increased. This condition is linked to reduced physical function, a decline in quality of life, and an increase in the risk of morbidity and mortality, particularly as a result of the complications of cardiovascular disease (3).…”