The prospective association between psychological distress and disease activity in rheumatoid arthritis: a multilevel regression analysis

Overman, C.L.; Bossema, Ercolie R.; Middendorp, Henriët van; Meij, Leoniek Wijngaards-de; Verstappen, Suzanne M M; Bulder, Marcia; Jacobs, Johannes W. G.; Bijlsma, J. W. J.; Geenen, Rinie

doi:10.1136/annrheumdis-2011-200338

Cited by 48 publications

(35 citation statements)

References 49 publications

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“…Stress and emotional problems have been suggested to influence IL-6 levels (41). However, studies yielded contradictory data with decrease (42,43), and psychological distress has not been proven to be a risk factor for exacerbation of disease activity (44). Clot formation during serum preparation has also been suggested to increase cytokine levels through myeloid cell activation (45); IL-6 concentration in serum and plasma is well correlated (46,47), but might be influenced by anticoagulant (47,48).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Serum Interleukin‐6 Level as a Surrogate Marker of Synovial Inflammation and as a Factor of Structural Progression in Early Rheumatoid Arthritis: Results From a French National Multicenter Cohort

Baillet¹,

Gossec

Paternotte

et al. 2015

Arthritis Care & Research

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Objective. Interleukin-6 (IL-6) is a key cytokine in rheumatoid arthritis pathogenesis. We aimed to analyze the association between IL-6 serum levels and joint inflammation at baseline and the correlation of time-integrated IL-6 values with structural damage during the first 36 months of early arthritis. Methods. IL-6 was assessed by 2 different methods in 813 patients of the French early arthritis cohort ESPOIR (Etude et Suivi des Polyarthrites Indiff erenci ees R ecentes) over 36 months. IL-6 and C-reactive protein (CRP) changes were correlated to radiographic progression assessed by the total Sharp/van der Heijde score (SHS). Synovium inflammation was assessed in a subgroup of 126 patients by ultrasonography (US). The relationship between SHS change and IL-6 or CRP levels at baseline was investigated by a univariate regression and a multivariable analysis. A longitudinal model nested by visit and patient was conducted to assess the role of IL-6 on SHS at each visit. Results. At baseline, IL-6 was more strongly correlated with the swollen joint count than CRP level. In the univariate analysis, the time-integrated value of IL-6 was more strongly correlated with the swollen joint count and the variation of SHS than timeintegrated CRP level. Baseline IL-6 was not independently associated with SHS change. Longitudinal models nested by patient showed that IL-6 levels were associated with structural damage independently from the Disease Activity Score in 28 joints, smoking status, rheumatoid factor, and anti-citrullinated protein peptide antibody serology, treatments, and CRP levels. Conclusion. IL-6 level was a marker of US synovitis at baseline. Repeated measurements of IL-6 are associated with structural damage.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Serum Interleukin‐6 Level as a Surrogate Marker of Synovial Inflammation and as a Factor of Structural Progression in Early Rheumatoid Arthritis: Results From a French National Multicenter Cohort

Baillet¹,

Gossec

Paternotte

et al. 2015

Arthritis Care & Research

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“…Cross-sectional studies provide conflicting results, with most describing an association between depressed mood and objective measures of disease activity, such as CRP and ESR [6,11,81,129,130]; however, others do not find such associations [131,132]. Some authors have found that anxiety does not correlate with ESR or CRP in RA patients [10,133], whereas others show that anxiety and disease activity were positively associated when measured simultaneously and 6 months apart [6]. While the latter study found some support for the condition that a higher level of disease activity is a risk factor for increased psychological distress, the findings did not confirm the hypothesis that psychological distress is a risk factor for future exacerbation of disease activity.…”

Section: The Das Score and Its Componentsmentioning

confidence: 99%

Psychological Factors Associated with Response to Treatment in Rheumatoid Arthritis

Santiago

Geenen²,

J.W.G.³

et al. 2014

CPD

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This paper presents a comprehensive review of research relating psychological domains with response to therapy in patients with rheumatoid arthritis. A holistic approach to the disease was adopted by incorporating not only disease activity but also dimensions of the impact of disease on patients' lives. Psychological distress, including depression and anxiety, is common among patients with rheumatoid arthritis and has a significant negative impact on response to therapy and on patients' abilities to cope with chronic illness. Evidence regarding the influence of positive psychological dimensions such as acceptance, optimism, and adaptive coping strategies is scarce. The mechanisms involved in these interactions are incompletely understood, although changes in neuro-endocrine-immune pathways, which are common to depression and rheumatoid arthritis, seem to play a central role. Indirect psychological influences on therapeutic efficacy and long-term effectiveness include a myriad of factors such as adherence, placebo effects, cognition, coping strategies, and family and social support. Data suggest that recognition and appropriate management of psychological distress may improve response to treatment and significantly reduce disease burden.

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“…The findings from different studies are, however, contradictory. Overman et al [13] found that psychological distress and disease activity were positively associated. Research has also shown that patients' emotions and support from family and friends play a crucial role in the course of RA [14,15], and that negative emotions appear to be recurrent experiences in relation to RA [16].…”

Section: Introductionmentioning

confidence: 99%

Emotions related to participation restrictions as experienced by patients with early rheumatoid arthritis: a qualitative interview study (the Swedish TIRA project)

et al. 2014

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The prospective association between psychological distress and disease activity in rheumatoid arthritis: a multilevel regression analysis

Cited by 48 publications

References 49 publications

Evaluation of Serum Interleukin‐6 Level as a Surrogate Marker of Synovial Inflammation and as a Factor of Structural Progression in Early Rheumatoid Arthritis: Results From a French National Multicenter Cohort

Evaluation of Serum Interleukin‐6 Level as a Surrogate Marker of Synovial Inflammation and as a Factor of Structural Progression in Early Rheumatoid Arthritis: Results From a French National Multicenter Cohort

Psychological Factors Associated with Response to Treatment in Rheumatoid Arthritis

Emotions related to participation restrictions as experienced by patients with early rheumatoid arthritis: a qualitative interview study (the Swedish TIRA project)

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