Achieving remission in patients lessens burden of RA on societies with aging populations: Study

Achieving disease remission in patients with rheumatoid arthritis (RA) provides superior outcomes across measures of socio-economic importance including work productivity and quality of life according to results presented today at EULAR 2010, the Annual Congress of the European League Against Rheumatism in Rome, Italy. These Austrian findings are reported in addition to improvements in measures of physical functioning, when compared with RA patients achieving low disease activity (LDA).

Results from this cross-sectional study of 356 patients showed statistically significant differences>

• Effect on work productivity, based on results of the Work Productivity and Activity Impairment (WPAI) index: impairment while working 11.3% vs. 27.2%, overall activity impairment 18.1% vs. 33.8%, REM vs LDA respectively
• Impact on quality of life, based on results of the Euro Qol (5D EQ-5D) index: 0.89 vs. 0.78 and the SF-36 PCS index: 46.2 vs. 37.8
• Impact on physical functioning, based on results of the Health Assessment Questionnaire (HAQ) scores: 0.38 vs. 0.75.

"We know that RA as a chronic disease often has a long term impact on patients' functional ability, affecting not only patients' well-being but also their working lives. The majority of those affected report a loss of productivity at work, and many even have to stop work altogether," said Dr. Helga Radner, Department of Rheumatology, Medical University Vienna, Austria and lead author of the study. "Our study results show that the benefits of achieving clinical remission are worthwhile, especially from a socio-economic point of view, as it decreases the 'burden of disease' not only for patients but also for society on a wider scale. The findings reveal that remission is even superior to an almost perfect disease activity state, namely low disease activity, therefore our major task in treating RA-patients should be its achievement and maintenance"

Interestingly, researchers found that the emotional aspects of the disease activity measures were similarly reported in patients in remission and in low disease activity indicating that once disease activity or symptom levels are reduced to a certain level, emotional discord may stabilise.

Longitudinal analysis over one year showed significant improvements when comparing the two patient populations in the following areas:

• Quality of life (EQ-5D); 0.89 vs. 0.80 (REM vs. LDA respectively), p < 0.001
• Percent of overall activity impairment (WPAI) per year; 12.2% vs. 31.0%, p < 0.001
• Physical disability (HAQ); 0.23 vs. 0.69,>

Significant differences between REM and LDA were not seen in the domain of percentage impairment while working (8.3% vs. 20.0% (REM vs. LDA respectively),>This study of 356 patients registered at the Department of Rheumatology at the Medical University of Vienna involved one cross sectional analysis (at a single time point) of RA patients, with 34 patients achieving REM (CDAI ≤2.8) and 66 patients achieving LDA (2.8≤CDAI<1).

Source: European League Against Rheumatism