Mood Disorders and Rheumatoid Arthritis: Updates From EULAR 2018

Jun 27, 2018

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.

Two studies recently presented at the Annual European Congress of Rheumatology (EULAR 2018) in Amsterdam, The Netherlands, address mood disorders in patients with rheumatoid arthritis (RA).

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.

anti-TNF, anti-tumor necrosis factor.

DAS28, Disease Activity Score 28; HR, hazard ratio; OPTTIRA, Optimizing TNF Tapering in RA.

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.