title: Functional disability can deteriorate despite suppression of disease activity in patients with rheumatoid arthritis: a large observational cohort study.
abstract: OBJECTIVE
  To analyze the relationship between the progression of disability and disease activity in patients with rheumatoid arthritis (RA) in daily practice.
  
  
  METHODS
  Patients from an observational cohort, IORRA, who completed surveys during 2009-2011 were eligible. Linear regression of disease activity score 28 (DAS28), Japanese version of Health Assessment Questionnaire (J-HAQ), and EQ-5D from baseline were calculated, and the angles of the regression lines were designated DAS28 slope, J-HAQ slope, and EQ-5D slope, respectively, in each patient; averages were compared between treatment groups.
  
  
  RESULTS
  A total of 5,038 patients [84.0% female, mean age 59.4 (SD 13.1) years, disease duration 13.2 (9.6) years, DAS28 3.29 (1.14), and J-HAQ 0.715 (0.760)] were analyzed. The average DAS28 slope indicated improvement in all groups, whereas J-HAQ slopes were negative in patients on methotrexate (MTX), biologics, combination biologics/disease-modifying antirheumatic drugs (DMARDs), and combination biologics/MTX at baseline, but positive in patients on prednisolone >5 mg/day [0.010 (0.153)] and not on MTX at baseline [0.007 (0.122)], representing a worsening of disability.
  
  
  CONCLUSIONS
  There is some disparity between improvement of disease activity and progression of disability, suggesting that quality of remission must be considered.
authors: Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan, seto@ior.twmu.ac.jp.
authors: Yohei
authors: Y
authors: Seto
authors: Eisuke
authors: E
authors: Inoue
authors: Kumi
authors: K
authors: Shidara
authors: Daisuke
authors: D
authors: Hoshi
authors: Naoki
authors: N
authors: Sugimoto
authors: Eri
authors: E
authors: Sato
authors: Eiichi
authors: E
authors: Tanaka
authors: Ayako
authors: A
authors: Nakajima
authors: Atsuo
authors: A
authors: Taniguchi
authors: Shigeki
authors: S
authors: Momohara
authors: Hisashi
authors: H
authors: Yamanaka
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000503:physiopathology*; D001688:Biological Products / Q000627:therapeutic use; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D008727:Methotrexate