Background/Purpose:

Rheumatoid Arthritis is a common inflammatory joint condition affecting up to 1% of the Northern Ireland population.  Patients often report increasing joint pain with changing weather conditions.  Previous studies examining the impact of weather on pain severity have yielded contradictory results (1,2).  The relationship between disease activity scores in Rheumatoid Arthritis patients and weather variance has not previously been examined.

Methods:

Patients attending the Biologics Therapy Unit at the Department of Rheumatology, Musgrave Park Hospital, Belfast; with a diagnosis of Rheumatoid Arthritis and receiving injectable anti-TNF therapy (Etanercept or Adalimumab) for a period of greater than 6 months were invited to participate.  A retrospective analysis of a total of 133 patients was performed.   Data collected at 5 time points included tender joint count, swollen joint count, patient visual analogue score, Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), and DAS-28 (Disease Activity Score).  This was correlated with maximum/minimum temperature, hours of sunshine, rainfall, relative humidity, pressure and wind-speed from a local weather station on the day of attendance.  A linear regression analysis was used to determine relationship between weather components, disease activity and pain.

Results:

The weather-based components were extracted after a global factor analysis using data from all time-points had revealed three weather components from the seven quantitative variables (maximum temperature, minimum temperature, hours of sunshine, mm rainfall, relative humidity, wind-speed and pressure).  These seven variables were converted to z-scores.  Three components indicated by the factor analysis were as follows: temperature component, sunny/dry component, wet /windy component.  All components were calculated from z-scores. 

Using DAS-28 as an outcome variable, when tested against weather components, it was evident that increased hours of sunshine and low humidity resulted in a lower das-28 score (p 0.001).  Sunny and dry conditions ((hours of sunshine – relative humidity)/2) resulted in a DAS-28 reduction of 0.143 (95% CI -0.230, -0.057) p=0.001.  Temperature component (max temperature + min temperature)/2 ­) resulted in a DAS-28 reduction of 0.048 (95% CI -0.129, 0.032), p = 0.23. Wet and windy conditions (rainfall + wind-speed – pressure)/3) led to a das-28 increase (0.013 (95%CI -0.098, 0.123) p=0.82.

Conclusion:

This study demonstrates statistically significant lower DAS-28 scores in sunny and dry conditions. A non-significant trend to higher DAS-28 scores in times of low temperature, and dull, wet and windy weather was also noted.

References

1. Drane D, Berry G, Bieri D, McFarlane AC, Brooks P.  The association between external weather conditions and pain and stiffness in women with rheumatoid arthritis. J Rheumatology1997; 24:1309–16.

2. Aikman H.  The association between arthritis and the weather.  Int J Biometeorol 1997; 40:192–9.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/does-rheumatoid-arthritis-disease-activity-correlate-with-weather-conditions/