ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1356

Disease Activity Of Rheumatoid Arthritis Is Influenced By Seasonal Change, As Analyzed Based On a Nationwide Japanese Cohort Database

Tetsuji Sawada1, Hiroaki Mori2, Kota Shimada3, Haeru Hayashi1, Koichiro Tahara1, Jinju Nishino4 and Shigeto Tohma5, 1Rheumatology, Tokyo Medical University, Tokyo, Japan, 2Rheumatology, Tokyo Meidical University, Tokyo, Japan, 3Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan, 4Nishino Clinic, Orthopedics and Rheumatology, Tokyo, Japan, 5Clinical Research Center for Allergy and Rheumatology, Sagamihara Hospital, National Hospital Organization, Sagamihara, Japan

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Rheumatoid Arthritis - Clinical Aspects II: Predictors of Disease Course in Rheumatoid Arthritis - Treatment Approaches

Session Type: Abstract Submissions (ACR)

Background/Purpose: Previous studies have suggested that environmental factors, such as weather, humidity and seasonal change, may affect rheumatoid arthritis (RA). In the present study, we aimed to determine whether there is seasonal variation in disease activity of RA, as assessed by subjective and objective components, using a nationwide Japanese cohort database, NinJa (National Database of Rheumatic Diseases by iR-net in Japan) in 2009, 2010 and 2011.

Methods: We analyzed data from RA patients, who were registered in NinJa and evaluated at any point during the indicated year, to evaluate seasonal effects on disease activity of RA, including tender joint count (TJC), swollen joint count (SJC), ESR, C-reactive protein (CRP), patient’s assessment of pain on a visual analogue scale (pain VAS), patient’s global assessment of disease activity (patient’s global VAS), physician’s global assessment of disease activity (physician’s global VAS), DAS28, Modified Health Assessment Questionnaire (MHAQ). 

Results:  Univariable analysis using NinJa 2011 database revealed that pain VAS and patient’s global VAS, which were subjective components of RA disease activity, as well as SJC, inflammatory markers (ESR and CRP), DAS28, mHAQ and physician’s global VAS were lowest during the fall months with statistical significance, although TJC was lowest in the summer months. Furthermore, it was reproducibly demonstrated that pain VAS, patient’s global VAS, DAS28 and physician’s global VAS were lowest during the fall months when analyzing using Ninja 2009 and 2010 database.

Conclusion: We have clearly demonstrated that RA disease activity, as assessed both subjectively and objectively, was lowest in fall. Seasonal changes can thus affect RA, which should be taken into account when examining RA patients to better understand their symptoms.

Spring  Summer  Fall   Winter
Number of patients  1905   628 1210   4398

TJC

2.63   1.65 2.01   2.97
SJC 2.34   2.42 1.54   1.77
ESR 29.9   27.3 26.1   32.0
CRP 0.68   0.64 0.57   0.70
pain VAS 2.71   2.84 2.25   2.76
mHAQ 0.50   0.47 0.45   0.49
patient’s global VAS 2.77   3.01 2.39   2.82
DAS28 2.64   2.53 2.40   2.66
physician’s global VAS  1.76   2.01 1.48   1.86

Disclosure:

T. Sawada,
None;

H. Mori,
None;

K. Shimada,
None;

H. Hayashi,
None;

K. Tahara,
None;

J. Nishino,
None;

S. Tohma,
None.

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