Disability, distress in RA patients cut in half over last 20 years

New research reveals that patients with rheumatoid arthritis (RA) today have an easier time with daily living than patients diagnosed two decades ago. According to results of the study published in Arthritis Care & Research, a journal of the American College of Rheumatology (ACR), anxiety, depressed mood and physical disability have been cut in half over the last 20 years. Researchers believe a reduction in disease activity is partly responsible for this positive change.

The World Health Organization (WHO) estimates that up to one percent of the world population experience pain and swelling of joints caused by RA, a systemic autoimmune disease. Over time, RA may impair daily function and lead to significant disability, with studies showing the disease is a threat to physical function and psychological well-being. However, improved treatment options including early therapy intervention, use of biologics, and more intensive therapy have helped to reduce disease activity.

"Earlier diagnosis, more intensive interventions along with recommendations to live a full life and to be physically active may help improve for those with RA," explains lead author, Cécile L. Overman, a Ph.D. Candidate with the Department of Clinical and Health Psychology, Utrecht University in The Netherlands. "Our study examined if psychological distress and physical disability in RA patients reduced over the last two decades."

For the present study, researchers recruited 1151 with newly diagnosed RA between 1990 and 2011. Participants were 17 to 86 years of age with 68% being female. Each participant was assessed at the time of diagnosis and monitored for the following three to five years.

Findings indicate that after the first four years of treatment 20 years ago, 23% of RA patients reported anxiety, 25% depressed mood, and 53% had physical disability compared to 12%, 14% and 31%, respectively, today. The decrease in physical disability remained significant even after adjusting for reduced disease activity. Results suggest that the downward trend in , anxiety, and depressed mood may be due in part to reduced disease activity.

"Our study determined that currently, 1 out of 4 newly diagnosed RA patients are disabled after the first four years of treatment; while 20 years ago, that figure was higher at 2 out of 4 patients," concludes Ms. Overman. "Today, RA patients have a better opportunity of living a valued life than diagnosed with this autoimmune disease two decades ago."

More information: "Patients with Rheumatoid Arthritis Nowadays are Less Psychologically Distressed and Physically Disabled Than Patients Two Decades Ago." Cécile L. Overman, Maud S. Jurgens, Ercolie R. Bossema, Johannes W.G. Jacobs, Johannes W.J. Bijlsma and Rinie Geenen. Arthritis Care and Research; Published Online: December 3, 2013 DOI: 10.1002/acr.22211

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