Relationship Between Depression and Disease Activity in United States Veterans With Early Rheumatoid Arthritis Receiving Methotrexate.
J Rheumatol
; 48(6): 813-820, 2021 06.
Article
em En
| MEDLINE
| ID: mdl-33191277
ABSTRACT
OBJECTIVE:
Depression is common in patients with rheumatoid arthritis (RA), exacerbates disease activity, and may decrease response to first-line disease-modifying antirheumatic drugs. This study aimed to determine if depression affects disease activity among veterans with early RA prescribed methotrexate (MTX).METHODS:
Participants included veterans enrolled in the Veterans Affairs Rheumatoid Arthritis (VARA) registry with early RA (onset < 2 yrs) prescribed MTX. Depression was assessed at enrollment using the International Classification of Diseases, 9th revision codes (296.2-296.39, 300.4, 311). Disease activity was measured using the Disease Activity Score in 28 joints (DAS28) and other core measures of RA disease activity. Propensity score weights were used to adjust depressed (n = 48) and nondepressed (n = 220) patients on baseline confounders within imputed datasets. Weighted estimating equations were used to assess standardized mean differences in disease activity between depressed and nondepressed patients at 6-month, 1-year, and 2-year follow-ups.RESULTS:
The analytic sample was composed of 268 veterans with early RA prescribed MTX who were predominantly male (n = 239, 89.2%) and older (62.7 yrs, SD 10.6) than patients with RA in the general population. Adjusted estimates indicated that depression was associated with significantly higher DAS28 at 6 months (ß 0.35, 95% CI 0.01-0.68) but not at the 1- or 2-year follow-up. Also, depression was associated with significantly worse pain at 6 months (ß 0.39, 95% CI 0.04-0.73) and 1 year (ß 0.40, 95% CI 0.04-0.75).CONCLUSION:
In early RA, depression is associated with greater short-term disease activity during MTX treatment, as well as more persistent and severe pain.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Veteranos
/
Antirreumáticos
Limite:
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Rheumatol
Ano de publicação:
2021
Tipo de documento:
Article