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
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 October 20, 2019.« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/physical-function-and-inflammatory-activity-in-rheumatoid-arthritis-patients-is-disease-duration-important/