THU0580-HPR Psychological Remission May BE Effective to Attain Remission of Boolean-Based Definition of Patient Global Assessment in Patients with Rheumatoid Arthritis. (10th June 2014)

• Record Type: Journal Article
• Authors: Fusama, M.; Yukioka, K.; Kuroiwa, T.; Yukioka, C.; Inoue, M.; Nakanishi, T.; Murata, N.; Takai, N.; Higashi, K.; Miura, Y.; Kuritani, T.; Maeda, K.; Sano, H.; Yukioka, M.; Nakahara, H.
• Is Part Of: Annals of the rheumatic diseases. Volume 73:Supplement 2(2014)
• Page Start: 1193
• Page End: 1194
• Publication Date: 2014-06-10
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2014-eular.2438
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: The patients with rheumatoid arthritis (RA) often do not meet patient global assessment (PGA) remission criterion despite a good clinical disease state and, therefore, PGA is not solely influenced by RA disease activity. It has been reported that PGA is a limiting factor for reaching remission. Objectives: We evaluated whether psychological state is related to Boolean-based definition of PGA remission for patients with RA. Methods: The patients with RA (n=146) were recruited. Swollen joint counts (SJC), tender joint counts (TJC), PGA and CRP were evaluated. Among patients with RA enrolled, those with good disease activity of RA (SJC≤1, TJC≤1, CRP≤1) were selected. These patients were divided into 2 groups, PGA remission group (PGA≤1cm) and PGA non-remission group (PGA>1cm). We compared psychological states between these 2 groups. Anxiety and depression were examined utilizing the Hospital Anxiety and Depression Scale-Depression (HADS-D) and -Anxiety (HADS-A), respectively. Depression was also evaluated with the Center for Epidemiologic Studies Depression Scale (CES-D). Comparison analyses were performed between PGA remission group (VAS≤1cm) and PGA non-remission group (VAS>1cm) in HADS-A, HADS-D and CES-D. Data analyses were performed utilizing Wilcoxon rank sum test. Results: The patients with RA satisfied with SJC≤1, TJC≤1 and CRP≤1 were selected (n=76). Patient characteristics of PGA remission group (n=45) and PGA non-remission group (n=31) were as follows: mean ± SD of age (53.02±1.75, 55.39±2.29 years) and duration (8.85±6.68, 8.93±7.09, years), male/female (9/39, 8/25, patients). There was no significant difference between PGA remission group and PGA non-remission group in age, sex, Steinbrocker's class and stage and disease duration (p=0.4043, p=0.7827, p=0.3936, p=0.5024 and p=0.9619, respectively). HADS-A was significantly lower in PGA remission group compared with that in PGA non-remission group (mean ± SD; 2.71±3.14, 4.32±3.57, respectively, p=0.026). HADS-D was also significantly lower in PGA remission group compared with that in PGA non-remission group (mean ± SD; 2.71±3.03, 4.77±3.87, respectively, p=0.010). Another measure of depression, CES-D, was also significantly better in PGA remission group compared with that in PGA non-remission group (mean ± SD; 9.16±6.00, 14.48±8.41, respectively, p=0.0017). Conclusions: The patients with RA who do not meet PGA remission criterion despite a good clinical disease state were in worse psychological state compared with those satisfied with Boolean-based definition of clinical remission. As PGA remission is thought to be a limiting factor for Boolean remission and PGA relates to psychological state, support for psychological state might be important to attain true remission. Disclosure of Interest: : None declared DOI: 10.1136/annrheumdis-2014-eular.2438