Session Information
Title: Rheumatoid Arthritis - Clinical Aspects (ACR): Comorbidities, Treatment Outcomes and Mortality
Session Type: Abstract Submissions (ACR)
Background/Purpose:
To evaluate whether gender portends a differential impact in the outcome of RA in terms of quality of life (QOL) and which type of variables may cause such effect.
Methods:
Seventy female and 70 male RA unselected patients followed in our division were cross-sectionally evaluated according to a pre-established protocol. It includes: medical history review, standardized measurements of disease severity (biological parameters, DAS28 activity index, HAQ index, modified Sharp-van der Heidje scoring method) as well as specific tools to assess comprehensively different psychological and disease related behavior and coping aspects (The Beck Depression Scale, The ISEL questionnaire for social support, The illness behavior abnormalities using the Illness Behavior Questionnaire (IBQ),The Rheumatology Attitude Index, and the level of disease with the Self-efficacy Questionnaire). QOL was assessed by the SF-36 questionnaire. Univariate and multivariate analyses were performed to examine the different contribution of these variables in both genders in the final outcome of the disease assessed in terms of QOL.
Results:
Both groups were homogeneous regarding to age at diagnosis (49.92+13.43 vs 52.94+13.63; p=0.189), disease duration (2472.48+2236.46 vs2441.62+2220.26 days; p=0.93), disease activity by DAS28 (3.81+1.49 vs 3.5+ 1.43, p=0.21), functional impairment by HAQ (0.89+ 2.61 vs 0.22+0.96, p=0.04) or radiologic damage by SVH score (24.6+48.4 vs men 22.1+ 27.7; p= 0.71). Regarding to comorbidity, men had a higher prevalence of ischemic heart disease (1.43% vs 11% p=0.029), chronic pulmonary obstructive disease, COPD (2.86% vs17.14% p=0.005), and conversely women had higher prevalence of osteoporosis (18.57% vs 5.71, p=0.02 and received more frequently anti-resortive therapy (15.71% vs 5.71%, p=0.056). Regarding to psychological variables, women presented significant higher scores in the Beck scale (10.78+7.52 vs 7.83+ 6.85, p=0.016) and numerically worse IBQ results (11.91+6.07 vs 10.55+ 5.88, p=0.181); not finding differences in the rest of studied physochological and behavioral variables. A greater impairment in the physical functioning (PF) subscale of SF36 was observed among female patients (57.78 + 22.11 vs 67.30 + 22.75; p=0.01). In the different models of multivariate analyses performed, Beck Scale (p=0.000), and the presence of osteoporosis (p=0.000) remained independently associated with the SF36 results.
Conclusion:
Female RA patients have lower levels of quality of life than their male counterparts. Psychological variables as a higher level of depressive symptoms and, maybe, a worse disease related behavior as well as a higher incidence of osteoporosis plays a major role in this result, rather than pure biological disease related variables. This fact should be taken into account in the management of these patients.
Disclosure:
E. Aurrecoechea,
None;
J. Calvo-Alen,
None;
G. S. Alarcon,
None;
G. McGwin Jr.,
None;
M. L. Diez Lizuain,
None;
J. Llorca,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/differential-gender-impact-in-the-quality-of-life-of-patients-with-rheumatoid-arthritis-comprehensive-study-including-clinical-comorbidity-and-psicho-social-variables/