Session Information
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Known since 1859, RA is the most common inflammatory joint disease with 0.5-1% worldwide prevalence. Currently, there is a larger number of medications and strategies for treating RA earlier and more aggressively, which also necessitates a greater understanding of the current burden of RA. Our objective is to measure the impact of RA on the individual and society through patient reported outcomes using a large US registry.
Methods:
We performed descriptive statistics of a random observation from RA patients enrolled in the National Data Bank for Rheumatic Diseases (NDB), a longitudinal US-wide study with comprehensive 6-month questionnaires from 1998-2017. We limited analysis to observations in the last decade (2007-2017) with a comparison to the previous 8 years (1998-2006). Health-related Quality of Life measures examined included HAQ, EQ5D, SF-36, activities of daily living, economic factors, and illness-related employment. With each of these individual testing measures, a total of 65 variables were considered for comparable analysis. Results:
Our study included 18,168 participants in the last decade with 82.2% female, mean (SD) age of 60.6 (13.5) and RA duration of 15.7 (12.1) years. The 1998-2006 cohort included 20,412 patients, with 77.1% female, age of 60.4 (13.5) and RA duration of 14.2 (11.0) years. Descriptive item responses are detailed in Table. Patient reported consequences of the burden within the 2007-2017 cohort show a slight improvement in HAQ, pain, fatigue, and SF-36 physical component score (PCS), but a worsening in global severity, sleep, SF-36 mental component score (MCS), quality of life (QOL) scale, health satisfaction, and functional limitations. When stratified by RA duration (Figure), patients with a duration of ²2 years had the lowest HAQ, pain, PCS, comorbidities, functional limitations and a higher QOL while duration of >20 years had the lowest fatigue, sleep and MCS score. Patients that took a DMARD or Biologic showed a definite improvement over patients that did not take any or prednisone. Conclusion:
Even in this era of effective new treatments, we found the burden of RA to still be severe and important. Current analyses show that HrQOL measures appear to be less related to type of treatment than decade of RA onset. Further analysis will be performed evaluating biologic vs. non-biologic treatments.
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Table. Characterization of RA patients by decade.
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2007-2017
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1998-2006
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N=18.168
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N=20.412
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Variable
|
Mean
|
SD
|
|
Mean
|
SD
|
P-value
|
|
Age (years)
|
60.6 |
13.5 |
60.4 |
13.4 |
0.2 |
|
|
Sex (% male)
|
17.8 |
|
|
22.9 |
|
<0.01 |
|
Disease duration (years)
|
15.7 |
12.1 |
14.1 |
11.0 |
<0.01 |
|
|
Married (%)
|
65.8 |
|
|
67.9 |
|
<0.01 |
|
Total Income (US dollars)
|
54771.7 |
35033.9 |
44973.7 |
29141.5 |
<0.01 |
|
|
HAQ (0-3)
|
1.0 |
0.7 |
|
1.1 |
0.7 |
<0.01 |
|
Pain (0-10)
|
3.9 |
2.8 |
4.0 |
2.8 |
0.3 |
|
|
Global severity (0-10)
|
3.8 |
2.5 |
|
3.7 |
2.5 |
<0.01 |
|
Fatigue (0-10)
|
4.4 |
3.0 |
4.5 |
3.0 |
<0.01 |
|
|
Sleep disturbance (0-10)
|
4.1 |
3.2 |
|
3.8 |
3.1 |
<0.01 |
|
Physical component score (SF-36)
|
36.9 |
11.2 |
35.9 |
11.1 |
<0.01 |
|
|
Mental component score (SF-36)
|
48.0 |
11.8 |
|
49.1 |
11.5 |
<0.01 |
|
Comorbidity Index (0-9)
|
2.0 |
1.7 |
1.7 |
1.5 |
<0.01 |
|
|
VAS QOL scale (0-100)
|
64.6 |
20.8 |
|
66.0 |
20.8 |
<0.01 |
|
Health satisfaction (0-4) |
1.9 |
1.3 |
1.8 |
1.2 |
<0.01 |
|
|
Functional Limitations |
7.4 |
5.4 |
|
7.1 |
5.3 |
<0.01 |
|
Function Now compared to 6 Months |
2.9 |
1.0 |
2.9 |
0.9 |
<0.01 |
|
|
Pain Now compared to 6 Months |
3.0 |
1.0 |
|
2.9 |
1.0 |
0.1 |
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Health Aides
|
Mean
|
SD
|
|
Mean
|
SD
|
P-value
|
|
Cane |
0.3 |
0.4 |
0.2 |
0.4 |
<0.01 |
|
|
Crutches |
0.0 |
0.1 |
|
0.0 |
0.1 |
<0.01 |
|
Walker |
0.1 |
0.3 |
0.1 |
0.3 |
<0.01 |
|
|
Wheelchair |
0.1 |
0.3 |
|
0.0 |
0.2 |
<0.01 |
|
Person Help-Dressing & Grooming |
0.1 |
0.3 |
0.1 |
0.3 |
<0.01 |
|
|
Person Help-Arising |
0.1 |
0.3 |
|
0.1 |
0.3 |
0.3 |
|
Person Help-Eating |
0.0 |
0.1 |
0.0 |
0.1 |
0.9 |
|
|
Person Help-Walking |
0.1 |
0.3 |
|
0.1 |
0.3 |
<0.01 |
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Economic
|
Mean
|
SD
|
|
Mean
|
SD
|
P-value
|
|
Employed at Onset of Disease |
0.8 |
0.4 |
0.8 |
0.4 |
<0.01 |
|
|
Retired Early due to Arthritis or Pain |
0.3 |
0.5 |
|
0.3 |
0.5 |
<0.01 |
|
Retired Early due to Other Medical |
0.1 |
0.3 |
0.1 |
0.3 |
<0.01 |
|
|
Days Limited Activity in 6 Months |
40.2 |
56.9 |
|
44.8 |
0.4 |
<0.01 |
|
Days Health kept from Usual Activities (30 days)
|
8.0 |
10.1 |
7.5 |
10.0 |
<0.01 |
|
|
Able to Perform Activities Completely |
2.6 |
1.1 |
|
2.6 |
1.1 |
<0.01 |
|
Financial Problem After Insurance (No/Limited. Moderate. Great) |
1.6 |
0.7 |
1.6 |
0.7 |
<0.01 |
|
|
Patient or Family Member Pay for All or Part Insurance |
0.7 |
0.4 |
|
0.7 |
0.4 |
0.4 |
|
Problem of Paying for Medical Insurance (No/Slight/Moderate/Great) |
0.9 |
1.0 |
0.9 |
1.0 |
0.5 |
|
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Medications
|
Mean
|
SD
|
|
Mean
|
SD
|
P-value
|
|
DMARD or biologic (%)
|
84.2 |
83.8 |
<0.01 |
|||
|
DMARD (%)
|
71.4 |
|
|
77.0 |
|
<0.01 |
|
Biologic (%)
|
49.2 |
34.8 |
<0.01 |
|||
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Current DMARDs (count)
|
0.9 |
0.7 |
|
1.1 |
0.8 |
<0.01 |
|
No DMARD/biologic or prednisone (%)
|
12.0 |
|
|
12.2 |
|
0.7 |
Figure. Means of health-related Quality of Life measures by decade and RA duration.
To cite this abstract in AMA style:
Schumacher R, Dominique A, Pedro S, Simon T, Michaud K. What Does It Mean to Have Rheumatoid Arthritis Now? a Current Burden of Disease Assessment in the United States [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/what-does-it-mean-to-have-rheumatoid-arthritis-now-a-current-burden-of-disease-assessment-in-the-united-states/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/what-does-it-mean-to-have-rheumatoid-arthritis-now-a-current-burden-of-disease-assessment-in-the-united-states/