Mental health is clearly tied to disease activity in RA. Here: the implications for clinical practice.
References1. Fragoulis GE, Cavanagh J, Derakhshan MH, et al. Depression and anxiety in an early rheumatoid arthritis inception cohort: associations with epidemiological, socioeconomic and disease features. Presented at: EULAR 2018; June 13-16, 2018; Amsterdam, The Netherlands. Abstract OP0350.2. Bechman K, Sin FE, Ibrahim F, et al. Psychological and functional states predict disease flare following TNF inhibitor tapering in patients with rheumatoid arthritis: a post-hoc analysis of data from the Optimizing TNF Tapering in RA (OPTTIRA) cohort. Presented at: EULAR 2018; June 13-16, 2018; Amsterdam, The Netherlands. Abstract THU0115.
In the first study, Fragoulis and colleagues found a strong association between RA and depression and anxiety.1 In the second study, Bechman and fellow researchers in the UK uncovered a link between psychological and functional status that predicts flares in RA.2
Thumb through the slides for the details of the two studies and the take-home points for clinicians.
BMI, body mass index; DAS28, Disease Activity Score 28.
Anxiety score at baseline was associated with female gender, younger age, and patient global assessment (PGA) score, and at months 6 and 12 with low BMI. Depression scores were associated with PGA scores at months 6 and 12 as well as with C-reactive protein (CRP) levels and baseline depression and anxiety scores.
The primary outcome was flare, defined as an increase in DAS28 ≥ 0.6, and at least one additional swollen joint.
Mental health is clearly tied to disease activity in RA. Thus, assessment and treatment of mental health problems should be a routine part of RA management in line with a holistic patient-centered approach.
