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The relationship between depression and biologic treatment response in rheumatoid arthritis: An analysis of the British Society for Rheumatology Biologics Register.
Matcham, Faith; Davies, Rebecca; Hotopf, Matthew; Hyrich, Kimme L; Norton, Sam; Steer, Sophia; Galloway, James.
Afiliação
  • Matcham F; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Davies R; Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
  • Hotopf M; NIHR Manchester Biomedical Research Centre, Central Manchester Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
  • Hyrich KL; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Norton S; South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK.
  • Steer S; Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
  • Galloway J; NIHR Manchester Biomedical Research Centre, Central Manchester Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
Rheumatology (Oxford) ; 57(5): 835-843, 2018 05 01.
Article em En | MEDLINE | ID: mdl-29447376
Objective: To investigate the relationship between depressive symptoms and treatment response and disease activity in RA over a 1-year follow-up. Methods: Data from the British Society for Rheumatology Biologics Register were used, representing 18 421 RA patients receiving biologic treatment. Depressive symptoms were identified through one of three assessments: reporting a history of depression, the Medical Outcomes Survey 36-item Short Form or the EuroQol five-dimension scale. Logistic regression analyses examined the relationship between baseline depressive symptoms and odds of good treatment response by 1 year. Multilevel models addressed the association between baseline depressive symptoms and disease activity outcomes over 1-year follow-up, adjusting for age, gender, disease duration, comorbidities and baseline disease activity and physical disability. Results: Depression symptoms at biologic treatment initiation were associated with 20-40% reduced odds of achieving a good treatment response at 1 year. Depressive symptoms at baseline also associated with reduced improvement in disease activity over the course of follow-up. Patients with a history of depression or reporting symptoms of depression according to the EuroQol five-dimension scale showed reduced improvement in tender and swollen joints, patient global assessment and ESR over 1-year follow-up. Patients with depression symptoms according to the 36-item Short Form showed reduced improvement in tender and swollen joints, but not ESR or patient global assessment. Conclusion: Experiencing symptoms of depression at the start of biologics treatment may reduce the odds of achieving a good treatment response, and reduce improvement in disease activity over time. Depression should be managed as part of routine clinical care to optimize treatment outcomes.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Artrite Reumatoide / Reumatologia / Sociedades Médicas / Produtos Biológicos / Sistema de Registros / Depressão Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Rheumatology (Oxford) Assunto da revista: REUMATOLOGIA Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Artrite Reumatoide / Reumatologia / Sociedades Médicas / Produtos Biológicos / Sistema de Registros / Depressão Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Rheumatology (Oxford) Assunto da revista: REUMATOLOGIA Ano de publicação: 2018 Tipo de documento: Article