title: Determinants of Disability in Rheumatoid Arthritis: A Community-Based Cohort Study.
abstract: Longitudinal care of a community-based cohort of patients with rheumatoid arthritis (RA) was evaluated retrospectively. Candidate determinants of disability included visual analog scales (VAS) for patient global assessment and pain, comorbidities, and medications. The outcome was the 'patient-acceptable symptom state' for disability as defined by the Health Assessment Questionnaire (HAQ) disability index, using a cutoff of <1.04. Two-sample t tests and multivariable logistic regression were used to determine odds ratios (OR) for associations between predictor variables and disability. Out of a total of 99 patients, 28 (28%) patients had HAQ ≥1.04 at their last visit. The greatest odds of not attaining the patient-acceptable symptom state in a multivariable model was associated with corticosteroids (OR: 5.1; p=0.02), antidepressants (OR: 5.3; p=0.02), and female sex (OR: 6.5; p=0.05). In the era of biologic therapy, female sex, corticosteroids, and antidepressants remain profound determinants of disability highlighting the need to understand the underlying mechanisms.
authors: Division of Rheumatology, Department of Medicine;
authors: Megan L
authors: ML
authors: Krause
authors: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research;
authors: Cynthia S
authors: CS
authors: Crowson
authors: Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
authors: Tim
authors: T
authors: Bongartz
authors: Division of Rheumatology, Department of Medicine;; Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA;
authors: Eric L
authors: EL
authors: Matteson
authors: Division of Rheumatology, Department of Medicine;
authors: Clement J
authors: CJ
authors: Michet
authors: Division of Rheumatology, Department of Medicine;
authors: Thomas G
authors: TG
authors: Mason
authors: Division of Rheumatology, Department of Medicine;
authors: Scott T
authors: ST
authors: Persellin
authors: Division of Rheumatology, Department of Medicine;; Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA;
authors: Sherine E
authors: SE
authors: Gabriel
authors: Division of Rheumatology, Department of Medicine;
authors: John M
authors: JM
authors: Davis
keywords: Depression; disability; rheumatoid arthritis.