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Disability, Distress in RA Patients Cut in Half Over Last 20 Years

Researchers cite reduced disease activity (December 3)

New research has shown that patients with rheumatoid arthritis (RA) have an easier time with daily living than had patients diagnosed two decades ago. According to a study published in Arthritis Care & Research, anxiety, depressed mood, and physical disability have been reduced by half over the last 20 years. Researchers believe a reduction in disease activity is partly responsible for this positive change.

The World Health Organization (WHO) estimates that up to 1% of the world’s population experiences pain and swelling of joints caused by RA, a systemic autoimmune disease. Over time, RA may impair daily function and lead to significant disability. However, improved treatment options, including early therapy intervention, the use of biologics, and more intensive therapy, have helped to reduce disease activity.

“Earlier diagnosis [and] more intensive interventions, along with recommendations to live a full life and to be physically active, may help improve daily living for those with RA,” said lead author Cécile L. Overman, a PhD candidate in the Department of Clinical and Health Psychology at Utrecht University in the Netherlands.

For the new study, researchers enrolled 1,151 subjects with newly diagnosed RA between 1990 and 2011. The participants were 17 to 86 years of age, with 68% being female. Each participant was assessed at the time of diagnosis and was monitored for the following 3 to 5 years.

The study found that, after the first 4 years of treatment 20 years ago, 23% of RA patients reported anxiety; 25% reported depressed mood; and 53% had physical disability compared with 12%, 14%, and 31%, respectively, today. The decrease in physical disability remained significant even after adjusting for reduced disease activity. These results suggest that the downward trend in physical disability, anxiety, and depressed mood may be partly due to reduced disease activity.

“Our study determined that currently, one out of four newly diagnosed RA patients are disabled after the first four years of treatment, while 20 years ago, that figure was higher at two out of four patients,” Overman concludes. “Today, RA patients have a better opportunity of living a valued life than patients diagnosed with this autoimmune disease two decades ago.”

Source: Wiley; December 3, 2013.

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