ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1056

Factors Associated with Impairment on Quality of Life in Early or Established RA Patients

Dam Kim1, Yoon-Kyoung Sung2,3, Soo-Kyung Cho1,3, Soyoung Won1, Minkyung Han1, So-Young Bang4, Hoon-Suk Cha5, Chan-Bum Choi2,3, Jung-Yoon Choe6, Won Tae Chung7, Seung-Jae Hong8, Jae-Bum Jun3, Young Ok Jung9, Jinseok Kim10, Seong-Kyu Kim11, Tae-Hwan Kim12, Tae-Jong Kim13, Eunmi Koh14, Choong Ki Lee15, Hye-Soon Lee16, Joo-Hyun Lee17, Jaejoon Lee18, Jisoo Lee19, Sang-Heon Lee20, Shin-Seok Lee21, Sung Won Lee22, Seung-Cheol Shim23, Dae-Hyun Yoo2, Wan-Hee Yoo24, Bo Young Yoon25 and Sang-Cheol Bae1,2, 1Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, South Korea, 2Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea, 3Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea, 4Department of Rheumatology, Hanyang University Guri Hospital, Guri, South Korea, 5Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, 6Division of Rheumatology, Catholic University of Daegu School of Medicine, Daegu, South Korea, 7Dong-A University Hospital, Busan, South Korea, 8Division of Rheumatology, Department of Internal Medicine, Kyung Hee University, Seoul, South Korea, 9Rheumatology dept, Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea, 10Jeju National University Hospital, Jeju, South Korea, 11Catholic University of Daegu School of Medicine, Daegu, South Korea, 12Division of Rheumatology, Department of Internal Medicine, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea, 13Chonnam Nat`l University Medical School&Hospital, Gwangju, South Korea, 14Dept of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, 15Internal medicine, school of medicine, Yeungnam University, Daegu, South Korea, 16Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea, 17Department of Rheumatology, Ilsan Paik Hospital, Inje University, Goyang, South Korea, 18Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, 19Ewha Womans University School of Medicine, Seoul, South Korea, 20Dept of Internal Medicine, Konkuk University Hospital, Seoul, South Korea, 21Division of, Chonnam National University Med School, Gwangju, South Korea, 22Dong-A university,Busan, South Korea, Pusan, South Korea, 23Chungnam National University Hospital, Daejeon, South Korea, 24Division of Rheumatology, Department of Internal Medicine, Chonbuk National University School of Medicine, Jeonju, South Korea, 25Inje University Ilsan Paik Hospital, Goyang, South Korea

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Epidemiology and Public Health (ACR): Rheumatoid Arthritis and Systemic Lupus Erythematosus Outcomes

Session Type: Abstract Submissions (ACR)

Background/Purpose

Rheumatoid arthritis (RA) is a chronic inflammatory disabling disease with significant impact on the quality of life (QOL) of patients. Since clinical features are different in RA patients according to the disease course, various factors might be influence on the low QOL depending on the phase of the disease. We aimed to explore the associating factors for impairment on quality of life in either early RA or established RA patients.

Methods

A total of 5,361 RA patients in the KORean Observational study Network for Arthritis (KORONA) were included in this study. The EuroQol-5 dimension (EQ-5D) is a widely used generic QOL instrument, and it allows for negative utility values, which correspond to health states worse than death. We defined the worst QOL as EQ-5D score < 0, a state worse than death. We classified RA patients according to their disease duration: early RA patients (n=714) as patients whose disease duration was less than 1 year and patients with longer disease duration formed the established RA patients (n=4,647). The distribution of EQ-5D in both groups of early and established RA patients were compared, and the possible determinants for negative EQ-5D score in each group were explored using the logistic regression analyses.

Results

The average EQ-5D score was not different between early and established RA patients (0.69±0.26 vs. 0.68±0.27, p=0.19), and the proportions of the negative EQ-5D score were comparable in both groups

(4.9% vs. 4.6%, p=0.76). The most important determinant for worst QOL in early RA patients was high functional disability (OR 17.3, CI 6.0-50.2). In addition, sleep disturbance (OR 1.02, CI 1.01-1.04) and fatigue (OR 1.04, CI 1.01-1.07) were another factors for worst QOL in early RA patients. In established RA patients, though the odds ratio was lower than early RA patients, high functional disability (OR 10.0, CI 7.1-14.3), sleep disturbance (OR 1.01, CI 1.00-1.01) and fatigue (OR 1.03, CI 1.02-1.04) were still associated with impairment on QOL. In addition, higher disease activity (OR 1.28, CI 1.08-1.51) increased risk for worst QOL but regular exercise (OR 0.66, CI 0.43-0.99) showed protective effect in established RA patients.

Conclusion

The functional disability, sleep disturbance and high fatigue level were significantly associated with the impairment on QOL in both early and established RA patients, while high disease activity had significant effects on the worst QOL only in patients with established RA. Regular exercise might have a protective effect against the impairment on QOL in established RA patients.

Table 1. Determinants of health state worse than death (EQ-5D<0) in early and established RA patients.

°°

Early RA

(n=714)

Established RA

(n=4,647)

Age

1.00(0.95-1.06)

1.01(0.99-1.03)

Female

0.70(0.15-3.16)

0.63(0.30-1.33)

Education

  Middle school or less

1.08(0.31-3.76)

1.25(0.77-2.05)

  High school or more

1.0(ref)

1.0(ref)

Income (X103 won)

  <2,000

2.83(0.27-30.08)

1.46(0.57-3.73)

  2,000°Â, <5,000

2.52(0.23-27.63)

1.58(0.61-4.07)

  °Ã5,000

1.0(ref)

1.0(ref)

Regular exercise, n(%)

1.41(0.44-4.47)

0.66(0.43-0.99)

Operation history due to RA, n(%)

0.63(0.06-6.24)

0.81(0.52-1.26)

Fracture history, n(%)

1.08(0.32-3.65)

0.88(0.57-1.38)

Sleep VAS(cm, mean±SD)

1.02(1.01-1.04)

1.01(1.00-1.01)

Fatigue VAS(cm, mean±SD)

1.04(1.01-1.07)

1.03(1.02-1.04)

DAS28-ESR

0.74(0.46-1.20)

1.28(1.08-1.51)

HAQ-DI

17.29(5.96-50.15)

10.02(7.05-14.25)

Comorbidities

0.64(0.21-1.93)

1.21(0.79-1.87)

Disclosure:

D. Kim,
None;

Y. K. Sung,
None;

S. K. Cho,
None;

S. Won,
None;

M. Han,
None;

S. Y. Bang,
None;

H. S. Cha,
None;

C. B. Choi,
None;

J. Y. Choe,
None;

W. T. Chung,
None;

S. J. Hong,
None;

J. B. Jun,
None;

Y. O. Jung,
None;

J. Kim,
None;

S. K. Kim,
None;

T. H. Kim,
None;

T. J. Kim,
None;

E. Koh,
None;

C. K. Lee,
None;

H. S. Lee,
None;

J. H. Lee,
None;

J. Lee,
None;

J. Lee,

Basic Science Research Program through the National Research Foundation (NRF) funded by the ministry of Education and Technology 2010-0010589 ,

2;

S. H. Lee,
None;

S. S. Lee,
None;

S. W. Lee,
None;

S. C. Shim,
None;

D. H. Yoo,
None;

W. H. Yoo,
None;

B. Y. Yoon,
None;

S. C. Bae,
None.

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