Abstract

Background:Recent advances of treatment for rheumatoid arthritis (RA) realizes us to set the treatment goal as remission. As the results, health assessment questionnaire (HAQ) has been also becoming better in these years. On the other hand, progress in ageing has been a major issue in Japan, including the patients with RA. which is thought as one of the factors affecting HAQ.Objectives:To evaluate the impact of ageing on HAQ in RA patients.Methods:The data of 208 RA patients used in this study was collected over a 7-year period from 2010 to 2017 as part of a prospective cohort study (TOMORROW Study: UMIN000003876) that included RA patients and age- and sex-matched volunteers recruited through mass media as controls. The data of RA patients included anthropometric, blood test data, disease activity score28-CRP (DAS28) and modified HAQ (mHAQ), together with baseline (BL) characteristics. The course of mHAQ for 7 years were analyzed by repeated measure ANOVA, and association between the changes of mHAQ at year-7 from BL (ΔmHAQ) and BL factors were analyzed by multiple regression analysis.Results:Two hundred and eight RA patients (153 women; mean age 58.1 years) were enrolled in the present study. Modified HAQ decreased significantly over the 7-year study period in RA patients. When the patients were stratified into 3 groups (lower than 2.7, between 2.7 and 4.1, over 4.1) by DAS28 at BL, mHAQ of the patients with high disease activity (DAS28: over 4.1) at BL was significantly worse than other groups (p=0.018; repeated measure ANOVA). There was no interaction between time and 3 groups (p=0.118; repeated measure ANOVA). Multiple regression analysis with ΔmHAQ as the outcome variable and ACPA, age, BMI, CRP, DAS28, MMP-3 at BL as independent variables revealed that age (p=0.034) and DAS28 (p=0.042) were independently related with ΔmHAQ.Conclusion:Ageing in RA patients impacted worsening of mHAQ over a 7-year period independently from disease activity. On assessing mHAQ in elderly RA patients, we must consider the age as well as the disease activity.Disclosure of Interests:Kentaro Inui Grant/research support from: Janssen Pharmaceutical K.K., Astellas Pharma Inc., Sanofi K.K., Abbvie GK, Takeda Pharmaceutical Co. Ltd., QOL RD Co. Ltd., Mitsubishi Tanabe Pharma, Ono Pharmaceutical Co. Ltd., Eisai Co.,Ltd.,, Speakers bureau: Daiichi Sankyo Co. Ltd., Mitsubishi Tanabe Pharma, Janssen Pharmaceutical K.K., Astellas Pharma Inc., Takeda Pharmaceutical Co. Ltd., Ono Pharmaceutical Co. Ltd., Abbvie GK, Pfizer Inc., Eisai Co.,Ltd., Chugai Pharmaceutical Co., Ltd., Yuko Sugioka: None declared, Tadashi Okano Grant/research support from: AbbVie, Eisai, Mitsubishi Tanabe Pharma Corporation and Nipponkayaku, Speakers bureau: AbbVie, Asahikasei, Astellas Pharma Inc, Ayumi Pharmaceutical, Bristol-Myers Squibb, Chugai Pharmaceutical, Daiich Sankyo, Eisai, Janssen, Lilly, Mitsubishi Tanabe Pharma Corporation, Novartis Pharma, Ono Pharmaceutical, Pfizer, Sanofi, Takeda Pharmaceutical, Teijin Pharma and UCB, Masahiro Tada: None declared, Kenji Mamoto: None declared, kazuki Orita: None declared, Hiroaki Nakamura Grant/research support from: Astellas Pharma Inc. and Asahi Kasei Pharma Co.

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