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.
ACR Meeting Abstracts - https://acrabstracts.org/abstract/factors-associated-with-impairment-on-quality-of-life-in-early-or-established-ra-patients/