Date: Monday, November 9, 2020
Session Type: Poster Session D
Session Time: 9:00AM-11:00AM
Background/Purpose: Patients with RA are at greater risk of mortality than the general population. Higher HAQ disability has been associated with hospitalizations and mortality in established RA; whether HAQ disability predicts mortality in early RA (ERA) is unknown.
Methods: Data were from adult early RA patients (symptoms < 1 year) enrolled in the Canadian Early Arthritis Cohort (CATCH) between 2007 and 2017; who initiated treatment with 1 or more DMARDs and had completed HAQ data at baseline and 1 year. Descriptive statistics, t-tests and chi-square tests were used to summarize and compare baseline patient characteristics including sociodemographic variables, RA characteristics and comorbidities amongst deceased and non-deceased patients. Discrete-time proportional hazards models were used to estimate crude and multi-adjusted associations between HAQ at baseline and 1 year, respectively, with all-cause mortality in each year of follow up.
Results: 1724 patients with early RA; mean age 55 years and 72% female were included. Over 10 years, 62 deaths (2.4%) occurred. Deceased patients had higher HAQ scores and DAS28(disease activity) scores at baseline and 1 year versus the non-deceased group. Age, male sex, lower education, smoking, more comorbidities, higher baseline disease activity and steroid use were associated with mortality in unadjusted survival models. Contrary to HAQ at baseline, the association between all-cause mortality and HAQ at 1 year remained significant even after adjusting for age, gender, comorbidities, disease activity, smoking, education, seropositivity, symptom duration and steroid use in adjusted survival models. HAQ baseline unadjusted hazard OR was 1.46 (CI 1.02-2.09) and adjusted 1.25 (CI 0.81-1.94) vs. HAQ at 1 year unadjusted hazard OR was 2.58 (CI 1.78-3.72) and adjusted 1.75 (CI 1.10-2.77).
Conclusion: Higher self-reported disability (high HAQ) at 1 year was significantly associated with all-cause mortality in a large early RA cohort suggesting that poorer disease control and function in the first year of RA contributes to higher mortality.
To cite this abstract in AMA style:Fatima S, Schieir O, Valois M, Bartlett S, Bessette L, Boire G, Hazlewood G, Hitchon C, Keystone E, Tin D, Thorne C, Bykerk V, Pope J, (CATCH) Investigators C. Health Assessment Questionnaire Predicts All-Cause Mortality at One Year in Patients with Early Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/health-assessment-questionnaire-predicts-all-cause-mortality-at-one-year-in-patients-with-early-rheumatoid-arthritis/. Accessed November 25, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/health-assessment-questionnaire-predicts-all-cause-mortality-at-one-year-in-patients-with-early-rheumatoid-arthritis/