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Ultrasound evaluation contrasts clinical disease activity evaluation in rheumatoid arthritis patients with concomitant anxiety or depression.
Michelsen, Brigitte; Sexton, Joseph; Kvien, Tore K; Provan, Sella Aarestad; Hammer, Hilde Berner.
Afiliación
  • Michelsen B; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; Research Unit, Sørlandet Hospital, Kristiansand, Norway. Electronic address: brigitte.michelsen@sshf.no.
  • Sexton J; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
  • Kvien TK; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
  • Provan SA; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; Section for Public Health, Inland Norway University of Applied Sciences, Hamar, Norway.
  • Hammer HB; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
Semin Arthritis Rheum ; 68: 152502, 2024 Jun 28.
Article en En | MEDLINE | ID: mdl-38972287
ABSTRACT

OBJECTIVES:

To compare disease activity as assessed by ultrasonography (US) between rheumatoid arthritis (RA) patients with and without anxiety or depression, and to compare clinical disease activity and sociodemographic measures between these patient groups.

METHODS:

Anxious or depressed patients were identified by EuroQoL-5D-3L question "I am not/moderately/extremely anxious or depressed." US assessments of 36 joints and 4 tendons were performed and power Doppler (PD) and grey scale (GS) sum scores calculated (both range 0-120). Comparisons between anxious/depressed and not anxious/depressed patients were performed in unadjusted analyses, adjusted logistic regression, and sensitivity analyses.

RESULTS:

A total of 201 RA patients starting biological disease-modifying antirheumatic drugs were included (82 % women, mean age 52 years, disease duration 10 years). Hundred-and-nine patients (54.2 %) were moderately or extremely anxious/depressed. Median (IQR) PD (13 (4, 21) vs. 10 (3, 20), p = 0.53) and GS (28 (18, 42) vs. 25 (14, 41), p = 0.51) sum scores were similar between anxious/depressed and not anxious/depressed patients, respectively, whereas composite scores of disease activity were significantly worse in the anxious/depressed patients (p < 0.001), as were also patient-reported outcomes, ESR, CRP and plasma calprotectin (all p ≤ 0.02). Sensitivity analyses confirmed these findings, except for CRP. Self-reported economy and sleep difficulties were also worse in the anxious/depressed patients and a higher proportion were not working (all p < 0.001).

CONCLUSION:

This study highlights the negative impact of anxiety and depression on RA patients in standard care, and underscores the challenges in disease activity assessment. US examination may be a valuable objective tool in the evaluation of these patients.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Idioma: En Revista: Semin Arthritis Rheum Año: 2024 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Idioma: En Revista: Semin Arthritis Rheum Año: 2024 Tipo del documento: Article