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Brazilian patients with moderate, severe RA experienced significantly worse disability
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Brazilian patients with moderate to severe rheumatoid arthritis were associated with significant functional disability and morbidity, according to study results.
Researchers conducted an observational cross-sectional study between November and December 2007 of 526 patients in Brazil with rheumatoid arthritis (RA; mean age, 51 years; 81% women). Information was provided by 55 rheumatologists, who rated patients’ RA as mild (n=219), moderate (n=227) or severe (n=55). Five hundred twenty-one patients completed questionnaires, which included the Work Productivity and Activity Impairment questionnaire, Health Assessment Questionnaire-Disability Index (HAQ-DI) and HAQ-Pain score, EuroQoL 5D and Functional Assessment of Chronic Illness Therapy-Fatigue.
Researchers also collected information on the amount of hospitalizations and health care consultations in the previous year, as well as patients’ RA drug therapy class.
When compared with patients with mild or moderate RA, patients with severe RA experienced more unemployment due to the disease (mild, 0%; moderate, 2%; severe, 11%; moderate-to-severe, P<.05) and greater disease duration (mild, 5.7 years; moderate, 6.3 years; severe, 9.3 years; mild-to-severe, P<.001; moderate-to-severe. P<.01). Increasing disease severity was related to the rise in overall work impairment (19%, mild; 36%, moderate; 65%, severe; mild-to-severe, P<.01; mild-to-moderate, P<.05) and activity impairment (mild, 27%; moderate, 46% and severe, 65%; each P<.001).
Worsening disability, pain, fatigue, quality of life, and perceived general health status were related to deteriorating health status and increased disease activity. Patients with severe RA had significantly higher hospitalization rates and overall consultation rates (for a 12-month period, 5.3 in mild RA; 6.0 in moderate RA; 7.1 in severe RA; mild-to-severe, P<.001; moderate to severe, P<.05).
“Disease severity should be considered when treating patients with RA,” the researchers concluded. “More aggressive treatment strategies may be needed to effectively manage patients with moderate to severe RA.”
Disclosure: See the study for a full list of relevant disclosures.
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