Abstract
Objectives This study investigated the relationship between quality of life (QOL) and several factors, including pain assessments, in patients with rheumatoid arthritis (RA). Methods This cross-sectional, single-center study enrolled 85 patients with RA. The variables investigated included demographic characteristics, the 28-joint disease activity score with C-reactive protein (DAS28-CRP), painDETECT questionnaire (PDQ), pain self-efficacy questionnaire (PSEQ), and pain catastrophizing scale (PCS). QOL was measured using the Japanese validated version of the European Quality of Life questionnaire with five dimensions and five levels (EQ-5D-5L). Results The use of oral steroids and oral analgesics was significantly associated with low EQ-5D-5L scores (P < 0.05). EQ-5D-5L score had a significant positive association with PSEQ (r = 0.414) and significant negative association with age, disease duration, DAS28-CRP, PDQ, and PCS (r = −0.217, −0.343, −0.217, −0.277, and −0.384, respectively). Multiple regression analysis showed that the use of oral analgesics and PSEQ were independent predictors of EQ-5D-5L score (β = -0.248, P < 0.05 and β = 0.233, P < 0.05). Conclusions The use of oral analgesics by RA patients may influence their QOL, which, in turn, may affect their feelings of self-efficacy. Various pain management strategies, including surgical treatment, may be explored for the treatment of RA. Furthermore, the PSEQ may be a prominent part of the patient's overall assessment.
Highlights
Rheumatoid arthritis (RA) is a chronic, progressive, systemic inflammatory autoimmune disease that causes joint deformity, pain, and functional disability [1, 2]
We aimed to investigate the variables that influence the quality of life (QOL) of patients with RA, using the EQ-5D-5L
All patients had a confirmed diagnosis of RA according to the 2010 American College of Rheumatology/European League Against Rheumatism [20]. e study variables included age, sex, body mass index (BMI), disease duration, presence and number of RA-related operations, use of MTX, use of biological disease-modifying antirheumatic drugs (bDMARDs), use of oral steroids, use and type of oral analgesics, use of synthetic DMARDs in patients with oral analgesics, serum matrix metalloprotease-3 (MMP-3) levels, EQ-5D-5L, disease activity score in 28 joints (DAS28)-CRP, painDETECT questionnaire (PDQ), pain self-efficacy questionnaire (PSEQ), and pain catastrophizing scale (PCS)
Summary
Rheumatoid arthritis (RA) is a chronic, progressive, systemic inflammatory autoimmune disease that causes joint deformity, pain, and functional disability [1, 2]. E combination of methotrexate and biological disease-modifying antirheumatic drugs (bDMARDs) has contributed to an increase in the number of patients who achieve clinical remission [4]. Disease activity in RA is often assessed using the disease activity score in 28 joints (DAS28) [5], which can further be combined with the C-reactive protein level (DAS28-CRP). 12.5% of patients with RA continue to report clinically significant pain despite achieving remission according to the DAS28-CRP score for more than 1 year [6]. A previous report examining patients with RA found that even those with low disease activity may have neuropathic pain [7]. Pain is usually associated with poor quality of life (QOL) in patients with RA [8]
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