Clinical and functional outcomes of Rheumatoid Arthritis with analysis of disease characteristics

Document Type : Original Article

Authors

1 Department of Rheumatology and Rehabilitation, Faculty of Medicine, Assiut University

2 Debartment of Biochemistry, Faculty of Medicine, Sohag University.

Abstract

Objective: To investigate the relationship between quality of life (QOL), Anti-cyclic citrullinated peptide (Anti-CCP)and disease activity in patients with rheumatoid arthritis (RA).
Methods:200 patients with RA were included in the study. Data were obtained by questionnaires and laboratory investigation, which included several generic and disease related QOL instruments. Separate dimensions and physical and mental summary scores of the Short form Health survey (SF-36) and Health Assessment Questionnaire (HAQ) were compared to study the relationship between clinical and laboratory parameters with QOL, (Anti-CCP)and other disease related variables.
Results: Physical health related QOL was reported to be worse, and mental health related QOL better, in RA than in control. There was highly significant association between Disease Activity Score (DAS-28)and Anti-CCP value (p <0.0001) comparing with control group. There were significance difference(P<0.05) about (HAQ) andSF-36 comparing with control.
Conclusions: RA has a significant effect on the health related qualityof life of patients. The disease duration was the most influencing factor on both the physical and mental function. Routine assessment of the HRQoL in those patients is recommended to detect and monitor the impact of the disease and its medications on different aspects.And a highly significant correlation was found between Anti-CCP value and disease activity in rheumatoid arthritis patients.

References

1.    Smolen JS, Landewé R, Bijlsma J, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis. 2017;73(3):492-509.
2.    Smolen JS, Breedveld FC, Burmester GR, Bykerk V, Dougados M, Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis. 2015 May 12.
3.    Huizinga TWJ, van der Helm-van Mil A. A quantitative approach to early rheumatoid arthritis. Bull NYU Hosp Joint Dis 2011; 69:116–21.
4.    Cader MZ, Filer A, Hazlehurst J, et al. Performance of the 2010 ACR/EULAR criteria for rheumatoid arthritis: comparison with 1987 ACR criteria in a very early synovitis cohort Ann Rheum Dis 2011; 70:949–55.
5.    Weinblatt ME, Keystone EC, Furst DE, Kavanaugh AF, Chartash EK, Segurado OG. Long term efficacy and safety of adalimumab plus methotrexate in patients with rheumatoid arthritis: ARMADA 4 year extended study. Ann Rheum Dis 2006;65:753–9.
6.    Anna Paula Ribeiro Campos; Cinthia Maria Silva; Shamyr Sulyvam de Castro; Cristiane Vitaliano Graminha, Depression and quality of life in rheumatoid arthritis individuals and stable health individuals: a comparative study. Fisioter. Pesqui. 2013;20(4).
7.    Sharpe L, Sensky T, Allard S. The course of depression in recent onset rheumatoid arthritis: the predictive role of disability, illness perceptions, pain and coping. J Psychosom Res. 2001;51(6):713-9.
8.    Costa AFC, Brasil MAA, Papi JA, Azevedo MNL. Depressão, ansiedade e atividade de doençan aartrite rheumatoid. Rev Bras Reumatol. 2008;48(1):7-11.
9.  Mella LFB, Bertolo MB, Dalgalarrondo P. Depressive symptoms in rheumatoid arthritis patients. Rev Bras Psiquiatr. 2010;32(3):257-63.
10. Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/ Euro-pean League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010;69:1580–1588.
11.  Castrejón1, A.M. Ortiz1, R. García-Vicuña1, J.P. Lopez-Bote1, A. Humbría1, L. Carmona2, I. Gonzalez-Alvaro1 sedimentation rate equivalent when estimating the 28-jointdisease activity score in rheumatoid arthritis? Clinical and Experimental Rheumatology 2008; 26: 769-775.
12.       Salaffi F, Carotti M, Ciapetti A,  Gasparini S,  Filippucci E and  Grassi W. Relationship between time-integrated disease activity estimated by DAS28-CRP and radiographic progression of anatomical damage in patients with early rheumatoid arthritis BMC Musculoskeletal Disorders 2011;120.
13.              Bukhari M, Thomson W, Naseem H, Bunn D, Silman A, Symmons D, Barton A: The performance of anti-cyclic citrullinated peptide antibodies in predicting the severity of radiologic damage in inflammatory polyarthritis: results from the Norfolk Arthritis Register. Arthritis Rheum. 2007, 56 (9): 2929-35.
14.              Klareskog L, Catrina AI, Paget S: Rheumatoid arthritis. Lancet. 2009, 21:373 (9664): 659-72.
15.              Kroot EJ, de Jong BA, van Leeuwen MA et al. The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis. Arthritis Rheum.2000, 43: 1831-5.
16.              Rajalingam S, Sakthiswary R, Hussein H. Anti-Citrullinated Cyclic Peptide Antibody and Functional Disability Are Associated With Poor Sleep Quality in Rheumatoid Arthritis Arch Rheumatol 2017;32(1):15-20.
 
 
 
 
 
 
 
 
 
 
17.              Hansen IM, Andreasen R, Bui Hansen et al. The Reliability of Disease Activity Score in 28 Joints–C-Reactive Protein Might Be Overestimated in a Subgroup of Rheumatoid Arthritis Patients, When the Score Is Solely Based on Subjective Parameters J Clin Rheumatol. 2017;23(2):102–6.
18.              Papadopoulos IA, Katsimbri P, Katsaraki A, et al. Clinical course and outcome of early rheumatoid arthritis. Rheumatol Int. 2011;20:205–210.
19.              IbnYacoub Y, Amine B, Laatiris A, Hajjaj-Hassouni N. Rheumatoid factor and antibodies against citrullinated peptides in Moroccan patients with rheumatoid arthritis: association with disease parameters and quality of life. Clin, Rheumatol 2012;31:329-34.
20.              Thyberg I, Dahlström Ö, Thyberg M. Factors related  to fatigue in women and men with early rheumatoid  arthritis: the Swedish TIRA study. J Rehabil Med. 2009;4:905-12.
21.              Chorus AMJ, Miedema HS, Wevers CWJ, van der Linden SM. Labour force participation among rheumatoid arthritis patients. Ann Rheum Dis .2000;59:549–54.
 
22.              Haroon N, Aggarwal A, Lawrence A et al. Impact of rheumatoid arthritis on quality of life. Mod Rheumatol. 2007;17:290–5.
1.    Smolen JS, Landewé R, Bijlsma J, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis. 2017;73(3):492-509.
2.    Smolen JS, Breedveld FC, Burmester GR, Bykerk V, Dougados M, Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis. 2015 May 12.
3.    Huizinga TWJ, van der Helm-van Mil A. A quantitative approach to early rheumatoid arthritis. Bull NYU Hosp Joint Dis 2011; 69:116–21.
4.    Cader MZ, Filer A, Hazlehurst J, et al. Performance of the 2010 ACR/EULAR criteria for rheumatoid arthritis: comparison with 1987 ACR criteria in a very early synovitis cohort Ann Rheum Dis 2011; 70:949–55.
5.    Weinblatt ME, Keystone EC, Furst DE, Kavanaugh AF, Chartash EK, Segurado OG. Long term efficacy and safety of adalimumab plus methotrexate in patients with rheumatoid arthritis: ARMADA 4 year extended study. Ann Rheum Dis 2006;65:753–9.
6.    Anna Paula Ribeiro Campos; Cinthia Maria Silva; Shamyr Sulyvam de Castro; Cristiane Vitaliano Graminha, Depression and quality of life in rheumatoid arthritis individuals and stable health individuals: a comparative study. Fisioter. Pesqui. 2013;20(4).
7.    Sharpe L, Sensky T, Allard S. The course of depression in recent onset rheumatoid arthritis: the predictive role of disability, illness perceptions, pain and coping. J Psychosom Res. 2001;51(6):713-9.
8.    Costa AFC, Brasil MAA, Papi JA, Azevedo MNL. Depressão, ansiedade e atividade de doençan aartrite rheumatoid. Rev Bras Reumatol. 2008;48(1):7-11.
9.    Mella LFB, Bertolo MB, Dalgalarrondo P. Depressive symptoms in rheumatoid arthritis patients. Rev Bras Psiquiatr. 2010;32(3):257-63.
10.              Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/ Euro-pean League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010;69:1580–1588.
11.              Castrejón1, A.M. Ortiz1, R. García-Vicuña1, J.P. Lopez-Bote1, A. Humbría1, L. Carmona2, I. Gonzalez-Alvaro1 sedimentation rate equivalent when estimating the 28-jointdisease activity score in rheumatoid arthritis? Clinical and Experimental Rheumatology 2008; 26: 769-775.
12.              Salaffi F, Carotti M, Ciapetti A,  Gasparini S,  Filippucci E and  Grassi W. Relationship between time-integrated disease activity estimated by DAS28-CRP and radiographic progression of anatomical damage in patients with early rheumatoid arthritis BMC Musculoskeletal Disorders 2011;120.
13.              Bukhari M, Thomson W, Naseem H, Bunn D, Silman A, Symmons D, Barton A: The performance of anti-cyclic citrullinated peptide antibodies in predicting the severity of radiologic damage in inflammatory polyarthritis: results from the Norfolk Arthritis Register. Arthritis Rheum. 2007, 56 (9): 2929-35.
14.              Klareskog L, Catrina AI, Paget S: Rheumatoid arthritis. Lancet. 2009, 21:373 (9664): 659-72.
15.              Kroot EJ, de Jong BA, van Leeuwen MA et al. The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis. Arthritis Rheum.2000, 43: 1831-5.
16.              Rajalingam S, Sakthiswary R, Hussein H. Anti-Citrullinated Cyclic Peptide Antibody and Functional Disability Are Associated With Poor Sleep Quality in Rheumatoid Arthritis Arch Rheumatol 2017;32(1):15-20.
 
 
 
 
 
 
 
 
 
 
17.              Hansen IM, Andreasen R, Bui Hansen et al. The Reliability of Disease Activity Score in 28 Joints–C-Reactive Protein Might Be Overestimated in a Subgroup of Rheumatoid Arthritis Patients, When the Score Is Solely Based on Subjective Parameters J Clin Rheumatol. 2017;23(2):102–6.
18.              Papadopoulos IA, Katsimbri P, Katsaraki A, et al. Clinical course and outcome of early rheumatoid arthritis. Rheumatol Int. 2011;20:205–210.
19.              IbnYacoub Y, Amine B, Laatiris A, Hajjaj-Hassouni N. Rheumatoid factor and antibodies against citrullinated peptides in Moroccan patients with rheumatoid arthritis: association with disease parameters and quality of life. Clin, Rheumatol 2012;31:329-34.
20.              Thyberg I, Dahlström Ö, Thyberg M. Factors related  to fatigue in women and men with early rheumatoid  arthritis: the Swedish TIRA study. J Rehabil Med. 2009;4:905-12.
21.              Chorus AMJ, Miedema HS, Wevers CWJ, van der Linden SM. Labour force participation among rheumatoid arthritis patients. Ann Rheum Dis .2000;59:549–54.
22.              Haroon N, Aggarwal A, Lawrence A et al. Impact of rheumatoid arthritis on quality of life. Mod Rheumatol. 2007;17:290–5.
 
Sohag Medical Journal
Volume 21, Issue 3
October 2017
Pages 43-50

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