OMERACT breakout groups call for more study into RA stiffness

Two Outcome Measures in Rheumatology 12 meeting breakout groups focused on stiffness in patients with rheumatoid arthritis and called for more research into measuring stiffness, along with its impact on patient quality of life, according to a recent report.

The results of two independent qualitative studies of stiffness were conducted with patients with rheumatoid arthritis (RA) were presented to the subgroups of the larger flare work group. The U.S. study comprised four focus groups with 20 patients and the U.K. group comprised one-on-one interviews with 16 patients with RA.

Patients in both of the studies described stiffness as a common RA symptom, but the degree of stiffness varied. Many patients reported stiffness at times other than in the morning, and that changes in stiffness were often associated with changes in other symptoms, particularly changes in pain, according to the report. Patients also reported that stiffness was not limited to certain joints. Many patients also reported that factors such as weather and immobility exacerbated stiffness.

According to the researchers, patients in both studies tended to describe stiffness in terms of the effects on daily life activities, such as getting dressed, driving, cooking and deciding whether to attend a social event.

Members of the two Outcome Measures in Rheumatology (OMERACT) groups emphasized the need to evaluate the effect of symptoms in addition to symptom severity. They wrote that stiffness has not consistently been linked to therapeutic response in clinical trials and has not been clearly defined. The usefulness of querying only the duration of morning stiffness in clinical trials, but consensus was not reached.

Overall, the groups agreed that further research is warranted into developing an optimal approach to measuring the relevant aspects of stiffness and incorporating terms used by patients to describe stiffness. Further, the groups recognized that stiffness is characteristic of certain other rheumatic diseases, such as ankylosing spondylitis, osteoarthritis, polymyalgia rheumatic and psoriatic arthritis, and that the effects should also be explored in these patient groups. The group endorsed the interest of creating an OMERACT stiffness special interest group to coordinate further research. – by Shirley Pulawski

Disclosure: OMERACT receives arms-length funding from 23 pharmaceutical companies. Please see the full study for a list of all other authors’ relevant financial disclosures.