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Abstract Number: 512

Physical Function and Inflammatory Activity in Rheumatoid Arthritis Patients. Is Disease Duration Important?

Emmanuel Bertiller1, Facundo Vergara1, Maria de los Angeles Gallardo1, Javier Rosa2, Erika Catay3, Marina Scolnik1, Maria Victoria Garcia4, Mirtha Sabelli5 and Enrique R. Soriano6, 1Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano de Buenos Aires, and Fundacion PM Catoggio, Buenos Aires, Argentina, 2Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina, 3Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano de Buenos Aires, and Fundacion PM Catoggio,, Buenos Aires, Argentina, 4Internal Services, Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano de Buenos Aires, and Fundacion PM Catoggio, Buenos Aires, Argentina, 5Cabrera 2964 Piso 6, Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano de Buenos Aires, and Fundacion PM Catoggio, Buenos Aires, Argentina, 6Internal Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Disease Activity, functional status and rheumatoid arthritis (RA), Health Assessment Questionnaire

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Session Information

Date: Sunday, November 8, 2015

Session Title: Rheumatoid Arthritis - Clinical Aspects Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: HAQ (Health Assessment Questionnaire) assesses functional disability in rheumatoid arthritis (RA) patients. Correlation between HAQ and disease activity might change according to the length of the disease. The purpose of our study was to assess this correlation in RA patients according to disease duration

Methods: RA patients ≥18 years (ACR/EULAR 2010 criteria) seen between March and May 2014 were included. At the inclusion visit: age, gender, disease duration, tender and swollen joint count (28 joints), disease activity by CDAI (Clinical Disease Activity Index) and physical function (HAQ-A, argentine Spanish validated version) were recorded. Patients were divided in two groups according to disease duration (≤ or >5 years). Variables were compared between both groups. Spearman correlation between CDAI and HAQ was calculated in each subgroup. Receiver Operating Characteristic (ROC) curve was used to assess the discriminating power of HAQ in patients in clinical remission (by CDAI), for the whole group and in the different age subgroups

Results: 104 patients, 91 females (88%), mean age of 60 years were included. Table 1 shows patients demographics and clinical features, by age group. While there were no significant differences in disease activity measurements, patients with longer disease duration had significantly worse HAQ-A. There was a significant correlation between HAQ-A and CDAI (r=0.50 p<0.001) for the total group. In patients with<5 years of disease duration (n=38) the correlation was r=0.69 (p<0.0001), whereas a lower correlation was found (r= 0.48 p<0.001) in patients with >5 years of disease duration (n=66). Patients on CDAI remission had significantly lower HAQ-A values than patients not in remission in both disease duration groups. However independently of remission status, patients with longer disease duration had significantly higher HAQ-A values than patients with short disease duration (table 2). The best cutoff value for HAQ–A to discriminate patients in remission (CDAI) using the ROC curve, in patients with shorter disease (≤5 years) was 0.125( AUC:0.85; 95% CI:0.74-0.96; Sensitivity (Se):76%; Specificity (Sp):92% and 0.875(AUC:0.81; 95% CI: 0.69-0.92 Se:59% Sp:90%) in patients with longer disease duration(>5 years)

Table 1

Characteristics

Total group (N= 104)

Disease duration < 5 years (n=38)

Disease duration > 5 years (n=66)

P value

Mean age (DS)

60 (14)

58.7 (16.7)

60.2 (11.7)

0.608

Females, n (%)

91 (88)

33 (87)

58 (88)

0.878

Mean years of Disease duration (SD)

10.1 (10.6)

1.3 (0.98)

15 (10.2)

<0.0001

Rheumatoid Factor positive, (n=96), n (%)

62 (65)

24/37 (65)

38/59 (64)

0.964

Anti-CCP positive, (n=87), n (%)

71 (82)

26/34 (76.5)

45/53 (85)

0.322

Mean CDAI (DS)

8,9 (10)

9.7 (12.2)

8.4 (8.4)

0.5320

Mean HAQ (DS)

0,64 (0,73)

0.37 (0.6)

0.8 (0.8)

0.0040

Mean pain VAS (DS)

29 (26,3)

27.3 (25.3)

29.7 (27.1)

0.6573

Mean VAS PGA  (DS)

27 (27)

27.1 (27.2)

26.9 (27.3)

0.9644

Mean VAS PhGA (DS)

22 (20)

21.7 (20.6)

22.9 (20.2)

0.7862

On Methotrexate, n (%)

83 (80)

33 (87)

50 (76)

0.175

On Biologics, n(%)

33(32)

1 (2.6)

32 (49)

<0.0001

On Steroids, n(%)

25(24)

12 (32)

13 (20)

0.175

 Table 2

 

CDAI remision (n=33)

CDAI no remision (n=71)

P value

Mean HAQ-A, (SD), Patients < 5 years disease duration

(n=13)

0,03 (0,1)

(n= 25)

0,55 (0,7)

0,0105

Mean HAQ-A, (SD), Patients > 5 years disease duration

(n=20)

0,3 (0,5)

(n= 46)

1 (0,8)

0,0002

P value

0.0264

0.0078

 

Conclusion: Correlation between disability measured by HAQ-A and disease activity measured by CDAI was better in patients with shorter disease duration.Patients with longer disease duration had higher functional disability independently of disease activity. Different HAQ-A values might need to be chosen as treatment targets for patients with different duration of disease


Disclosure: E. Bertiller, None; F. Vergara, None; M. D. L. A. Gallardo, None; J. Rosa, None; E. Catay, None; M. Scolnik, None; M. V. Garcia, None; M. Sabelli, None; E. R. Soriano, Abbvie; Janssen; UCB; Roche; Bristol Myers Squibb, 2,Abbvie; UCB; Janssen; Roche; Bristol Myers Squibb; Pfizer; Novartis, 8.

To cite this abstract in AMA style:

Bertiller E, Vergara F, Gallardo MDLA, Rosa J, Catay E, Scolnik M, Garcia MV, Sabelli M, Soriano ER. Physical Function and Inflammatory Activity in Rheumatoid Arthritis Patients. Is Disease Duration Important? [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/physical-function-and-inflammatory-activity-in-rheumatoid-arthritis-patients-is-disease-duration-important/. Accessed June 1, 2023.
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