Trends in Functional Disability and Determinants of Clinically Meaningful Change Over Time in Hispanic Patients With Rheumatoid Arthritis in the US

Karpouzas, George; Draper, Taylor; Moran, Rosalinda; Hernández, Elizabeth; Nicassio, Perry M.; Weisman, Michael H.; Ormseth, Sarah R.

doi:10.1002/acr.22924

Cited by 18 publications

(14 citation statements)

References 14 publications

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“…The most important factor which influences poor patient reported outcomes such as the HAQ and the AI is high disease activity [26]. In elderly RA patients' pain and depression are modifiable factors which are associated with disease activity and are therefore related to disability [16]. However, it is still unclear which assessment instruments should be used for longterm monitoring of RA patients.…”

Section: Resultsmentioning

confidence: 99%

“…As to the performance of the AI instrument in comparison to the standard HAQ, we estimated the extent to which HAQ and AI disability scores corresponded to each to previous studies [16,17]. The activity index is a short 8 items questionnaire covering the subdimensions pain, quality of life and restriction of participation in daily life focusing on household, leisure and job activities ( Figure 2).…”

Section: Introductionmentioning

confidence: 99%

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Monitoring the Time Course of Disability through a Self-Assessment Instrument "Activity Index" (IA) in RA Patients

Ren¹,

Zhang²,

ZG³

et al. 2018

J Rheum Dis Treat

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Background: Rheumatoid arthritis (RA) is a heterogeneous autoimmune disease whose etiopathogenesis is largely unknown. Available treatments, though effective, are insufficient in so far as there is no cure for a major proportion of patients. In those patients the disease becomes chronic with progressive joint damage, disability, and limitation of participation. Current treatment approaches include pain-relieving drugs and anti-inflammatory medications that slow joint damage, combined with physical therapies involving a well-balanced, highly personalized sequence of rest and exercise. As pain-relief, overall activity, mobility and participation are vital indicators of disability and response to RA treatment, regular patient feedback in this respect is key to a successful monitoring of the long-term effect of therapy. To manage such feedback, we have developed an easyto-use self-assessment tool "Activity Index" (AI) for tablets and smartphones that enables regular assessments of RA improvement and/or deterioration in the patients' home environment. In this normative study we addressed the questions of (1) The AI sensitivity regarding the resolution of small between-patient differences; and (2) The external validity of the AI instrument when compared with "objective" laboratory and x-ray measures and the HAQ disability index.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Monitoring the Time Course of Disability through a Self-Assessment Instrument "Activity Index" (IA) in RA Patients

Ren¹,

Zhang²,

ZG³

et al. 2018

J Rheum Dis Treat

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“…A few studies investigated the effect of depression on ADL in patients with RA. Karpouzas et al [3] reported that disease activity, depression, and pain contributed signi cantly to disability as assessed by HAQ-disability index in vulnerable Hispanic patients with RA living in the United States. Morris et al [23] reported that depression had signi cant adverse effects over time on daily functioning in a representative community sample of patients with RA.…”

Section: Discussionmentioning

confidence: 99%

“…Finding out causes of disability in patients with RA may facilitate development of measures to preserve independency in these patients. There is a recent trend toward exploring factors underlying disability in patients with RA [1][2][3][4][5][6][7][8][9][10]. Older adults are at a high risk for disability and in ammatory rheumatic disorders such as RA may further increase this risk.…”

Section: Introductionmentioning

confidence: 99%

Younger Patients With Rheumatoid Arthritis Are as Dependent in Activities of Daily Living as Their Older Counterparts

Tufan¹,

Tufan²,

Öksüz³

et al. 2020

Preprint

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Background: Rheumatoid arthritis is an important cause of disability and dependency in older adults. We aimed to assess dependency in activities of daily living in younger and older patients with rheumatoid arthritis and to seek factors underlying dependency in activities of daily living.Methods: In this cross-sectional study, we assessed dependency in basic and instrumental activities of daily living; disease activity; quality of life; depression; anxiety; and fatigue in the rheumatology clinic of a university hospital. Univariate analyses and a logistic regression analysis were performed to determine factors associated with dependency.Results: We enrolled 76 patients with a mean age of 57±11.1 (range 31-78). The rate of dependency in instrumental activities of daily living was high in younger (56.1%) and older (51.4%) patients. The rate of dependency in basic activities of daily living was 14.6% in younger and 14.3% in older patients. A higher depression score and female gender had significant associations with dependency in instrumental activities of daily living.Conclusion: The rate of dependency in basic and instrumental activities of daily living is high in younger and older patients with rheumatoid arthritis. Depression seems to be an independent and important factor underlying dependency. Further studies are needed to investigate the mechanisms of this association and test the effect of antidepressant treatment on dependency in rheumatoid arthritis.

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“…Вместе с тем, согласно имеющимся данным, даже в отсутствие психофармакотерапии регрессия симптомов депрессии сопровождается уменьшением активности заболевания по DAS28, выраженности боли и функциональных ограничений по HAQ [52,53]. Принимая во внимание тот факт, что ПР ассоциируются с более высокой активностью РА и низкой приверженностью лечению, можно предположить, что психофармакотерапия О р и г и н а л ь н ы е и с с л е д о в а н и я…”

Section: таблица 6aunclassified

Factors Influencing the Efficiency of Therapy in Patients With Rheumatoid Arthritis: The Role of Comorbid Mental and Somatic Diseases

Абрамкин¹,

Лисицына²,

Veltishchev³

et al. 2018

rsp

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The response rate to therapy for rheumatoid arthritis (RA) rarely exceeds 60%. Mental disorders (MDs) of the anxiety-depressive spectrum (ADS) and cognitive impairment (CI) substantially affect the evaluation of the efficiency of RA therapy. Adequate psychopharmacotherapy is one of the possible approaches to optimizing the treatment of RA. The factors influencing the efficiency of RA therapy with standard disease-modifying antirheumatic drugs (DMARDs) and biological agents (BAs) in combination with adequate psychopharmacotherapy have not been previously identified. Objective: to determine the predictors of response to therapy in patients with RA receiving DMARDs and BAs with or without adequate psychopharmacotherapy for ADS disorders. Subjects and methods. The investigation included 128 patients (13% men and 87% women) with a reliable diagnosis of RA. At baseline, 75.1% of patients received DMARDs; 7.8% – BAs. ADS disorders were detected in 123 (96.1%) patients. Psychopharmacotherapy was offered to all the patients with MDs; 52 patients agreed to treatment and 71 refused. The following therapeutic groups were identified according to the performed therapy: 1) DMARDs (n = 39); 2) DMARDs + psychopharmacotherapy (n = 43); 3) DMARDs + BAs (n = 32); 4) DMARDs + BAs + psychopharmacotherapy (n = 9). The changes of MDs symptoms and the outcomes of RA were assessed in 83 (67.5%) patients at five-year follow-up. The efficiency of RA therapy was evaluated with DAS28 (EULAR criteria). Predictors of response to therapy were determined using linear regression modeling. Results and discussion. At 5 years, 22 (26.5%) and 37 (44.6%) patients were recorded to show good and moderate responses to therapy, respectively; 24 (28.9%) patients were non-respondents. The linear regression model included 14 factors (p<0.001). The high values of DAS28 (β=0.258) at the inclusion; belonging to therapeutic groups 2 (β=0.267), 3 (β=0.235), and 4 (β=0.210), the absence of diabetes mellitus (β=-0.230), and experience in using glucocorticoids (β=-0.230) were associated with a high likelihood of response to therapy; high body mass index (β=-0.200) and long RA duration (β=-0,181), a high level of rheumatoid factor (β=-0.176), a history of myocardial infarction (β=-0.153), schizotypic disorder (β=-0.132), and extra-articular manifestations of RA (β=-0.106), and older age (β=-0.102) were related to a low probability of response. The area under the ROC curve for the model was 0.99 (p><0.001). Conclusion. BA therapy and psychopharmacotherapy, along with younger age, shorter duration and high activity of RA, a low level of rheumatoid factor, lower body mass index, the absence of diabetes mellitus, myocardial infarction, and extra-articular manifestations of RA in the history, schizotypic disorder, and experience in using glucocorticoids are associated with a greater likelihood of a good and moderate treatment response. Keywords: rheumatoid arthritis; mental disorders; disease-modifying antirheumatic drugs; biological agents; efficiency of therapy; predictors; psychopharmacotherapy; therapy adherence><0.001). The high values of DAS28 (β=0.258) at the inclusion; belonging to therapeutic groups 2 (β=0.267), 3 (β=0.235), and 4 (β=0.210), the absence of diabetes mellitus (β=-0.230), and experience in using glucocorticoids (β=-0.230) were associated with a high likelihood of response to therapy; high body mass index (β=-0.200) and long RA duration (β=-0,181), a high level of rheumatoid factor (β=-0.176), a history of myocardial infarction (β=-0.153), schizotypic disorder (β=-0.132), and extra-articular manifestations of RA (β=-0.106), and older age (β=-0.102) were related to a low probability of response. The area under the ROC curve for the model was 0.99 (p<0.001). Conclusion. BA therapy and psychopharmacotherapy, along with younger age, shorter duration and high activity of RA, a low level of rheumatoid factor, lower body mass index, the absence of diabetes mellitus, myocardial infarction, and extra-articular manifestations of RA in the history, schizotypic disorder, and experience in using glucocorticoids are associated with a greater likelihood of a good and moderate treatment response. Keywords: rheumatoid arthritis; mental disorders; disease-modifying antirheumatic drugs; biological agents; efficiency of therapy; predictors; psychopharmacotherapy; therapy adherence><0.001). Conclusion. BA therapy and psychopharmacotherapy, along with younger age, shorter duration and high activity of RA, a low level of rheumatoid factor, lower body mass index, the absence of diabetes mellitus, myocardial infarction, and extra-articular manifestations of RA in the history, schizotypic disorder, and experience in using glucocorticoids are associated with a greater likelihood of a good and moderate treatment response.

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Trends in Functional Disability and Determinants of Clinically Meaningful Change Over Time in Hispanic Patients With Rheumatoid Arthritis in the US

Cited by 18 publications

References 14 publications

Monitoring the Time Course of Disability through a Self-Assessment Instrument "Activity Index" (IA) in RA Patients

Monitoring the Time Course of Disability through a Self-Assessment Instrument "Activity Index" (IA) in RA Patients

Younger Patients With Rheumatoid Arthritis Are as Dependent in Activities of Daily Living as Their Older Counterparts

Factors Influencing the Efficiency of Therapy in Patients With Rheumatoid Arthritis: The Role of Comorbid Mental and Somatic Diseases

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