Dataset Information

A Prospective Evaluation of the Effects of Prevalent Depressive Symptoms on Disease Activity in Rheumatoid Arthritis Patients Treated With Biologic Response Modifiers.

ABSTRACT: PURPOSE:Depressive symptoms are common in rheumatoid arthritis (RA) and may affect disease activity and treatment outcomes. The objective of this study was to determine if prevalent depressive symptoms modify biologic treatment response through their effect on RA disease activity. METHODS:RA patients with depressive symptoms, initiating biologic treatment, were identified from a US RA registry sample. Patients with depression were compared with control subjects (ie, those patients with no reports of depressive symptoms at, or before, initiating therapy) in terms of clinical disease activity index (CDAI) remission and low disease activity (LDA), and the changes in the component measures that comprise this scale at 6 and 12 months of follow-up. Inverse probability weighting was used to account for differences in baseline disease severity, concomitant treatment characteristics, and other possible confounders. Logistic and linear regression models estimated differences in response rates and changes in component disease activity measures. FINDINGS:Depressive symptoms were associated with a decreased likelihood of CDAI remission at 6 months (odds ratio, 0.43 [95% CI, 0.19-0.96]) but not at 12 months (odds ratio, 0.83 [95% CI, 0.43-1.60]), and there was no effect on CDAI LDA. Adjusted core component measurement changes showed smaller decreases in global assessment ratings in patients with depressive symptoms; these associations were not statistically significant. IMPLICATIONS:Poorer treatment outcomes among RA patients with depressive symptoms may be a result of higher baseline disease severity. Adjusted estimates indicated symptoms of depression only affected remission at 6 months' follow-up through patient and physician global assessments. Thus, any impact of depressive symptoms during biologic treatment might not be due to a definitive impact on joint swelling and tenderness.

SUBMITTER: Rathbun AM

PROVIDER: S-EPMC4947560 | biostudies-literature | 2016 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

A Prospective Evaluation of the Effects of Prevalent Depressive Symptoms on Disease Activity in Rheumatoid Arthritis Patients Treated With Biologic Response Modifiers.

Rathbun Alan M AM Harrold Leslie R LR Reed George W GW

Clinical therapeutics 20160629 7

<h4>Purpose</h4>Depressive symptoms are common in rheumatoid arthritis (RA) and may affect disease activity and treatment outcomes. The objective of this study was to determine if prevalent depressive symptoms modify biologic treatment response through their effect on RA disease activity.<h4>Methods</h4>RA patients with depressive symptoms, initiating biologic treatment, were identified from a US RA registry sample. Patients with depression were compared with control subjects (ie, those patients ...[more]

PMID: 27368116

Similar Datasets

Project description:ObjectivesTo investigate the prevalence of depressive symptoms in rheumatoid arthritis (RA) patients using two previously validated questionnaires in a large patient sample, and to evaluate depressive symptoms in the context of clinical characteristics (e.g. remission of disease) and patient-reported impact of disease.MethodsIn this cross-sectional study, the previously validated Patient Health Questionnaire (PHQ-9) and Beck-Depression Inventory II (BDI-II) were used to assess the extent of depressive symptoms in RA patients. Demographic background, RA disease activity score (DAS28), RA impact of disease (RAID) score, comorbidities, anti-rheumatic therapy and antidepressive treatment, were recorded. Cut-off values for depressive symptomatology were PHQ-9 ≥5 or BDI-II ≥14 for mild depressive symptoms or worse and PHQ-9 ≥ 10 or BDI-II ≥ 20 for moderate depressive symptoms or worse. Prevalence of depressive symptomatology was derived by frequency analysis while factors independently associated with depressive symptomatology were investigated by using multiple logistic regression analyses. Ethics committee approval was obtained, and all patients provided written informed consent before participation.ResultsIn 1004 RA-patients (75.1% female, mean±SD age: 61.0±12.9 years, mean disease duration: 12.2±9.9 years, DAS28 (ESR): 2.5±1.2), the prevalence of depressive symptoms was 55.4% (mild or worse) and 22.8% (moderate or worse). Characteristics independently associated with depressive symptomatology were: age <60 years (OR = 1.78), RAID score >2 (OR = 10.54) and presence of chronic pain (OR = 3.25). Of patients classified as having depressive symptoms, only 11.7% were receiving anti-depressive therapy.ConclusionsMild and moderate depressive symptoms were common in RA patients according to validated tools. In routine clinical practice, screening for depression with corresponding follow-up procedures is as relevant as incorporating these results with patient-reported outcomes (e.g. symptom state), because the mere assessment of clinical disease activity does not sufficiently reflect the prevalence of depressive symptoms.Clinical trial registration numberThis study is registered in the Deutsches Register Klinischer Studien (DRKS00003231) and ClinicalTrials.gov (NCT02485483).

Dataset Information

A Prospective Evaluation of the Effects of Prevalent Depressive Symptoms on Disease Activity in Rheumatoid Arthritis Patients Treated With Biologic Response Modifiers.

Publications

A Prospective Evaluation of the Effects of Prevalent Depressive Symptoms on Disease Activity in Rheumatoid Arthritis Patients Treated With Biologic Response Modifiers.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets