RESEARCH - Does clinical remission lead to normalization of EQ-5D in patients with RA?

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J Rheumatol. 2010 Jan 15.

Does Clinical Remission Lead to Normalization of EQ-5D in Patients

with Rheumatoid Arthritis and Is Selection of Remission Criteria

Important?

Linde L, Sørensen J, Ostergaard M, Hørslev-sen K, Hetland ML.

From the Departments of Rheumatology, Copenhagen University Hospital,

Hvidovre, Glostrup; King Christian Xth Hospital for Rheumatic

Diseases, Gråsten; and Center for Applied Health Services Research and

Technology Assessment (CAST), University of Southern Denmark, Odense,

Denmark.

OBJECTIVE: To compare health-related quality of life (HRQOL) of

patients with rheumatoid arthritis (RA) to that of the general

population and to investigate the association with disease activity,

focusing on different clinical remission criteria.

METHODS: EQ-5D data from 3156 patients with RA from 11 Danish centers

were compared with Danish EQ-5D population norms (n = 16,136). The

Disease Activity Score (DAS28) and the Clinical Disease Activity Index

score (CDAI) were used as definitions of disease activity and clinical

remission. The score difference (EQ-5D) was calculated in each patient

as the difference from the age and sex-matched general population and

adjusted for age, marital status, education, body mass index, smoking,

exercise habits, disease duration, IgM-rheumatoid factor status, joint

surgery, extraarticular features, treatment, and comorbidity in

multiple linear regression models.

RESULTS: 37% vs 22% fulfilled the DAS28 and CDAI remission criteria,

respectively. The EQ-5D values for women/men in clinical remission

were DAS28 0.05/0.06 vs CDAI 0.01/0.02; low disease activity: DAS28

0.12/0.13 vs CDAI 0.11/0.14; moderate disease activity: DAS28

0.18/0.20 vs CDAI 0.20/0.23; and high disease activity: DAS28

0.38/0.28 vs CDAI 0.33/0.26. Adjusting for confounders reduced the

EQ-5D values between 0 and 0.04 units.

CONCLUSION: Patients with RA had worse EQ-5D scores than the general

population, and the difference was strongly associated with disease

activity. The EQ-5D score for patients in clinical remission

approached that of the general population, suggesting that strict

treatment goals are critical in order to achieve near-normal HRQOL in

patients with RA.

PMID: 20080905

http://www.ncbi.nlm.nih.gov/pubmed/20080905

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