A delay in treatment for RA patients significantly elevates the likelihood of joint damage and onset of disability 2 years out, according to researchers from the Hospital of Special Surgery (HSS). The study was presented at the annual meeting of the American College of Rheumatology/Association of Rheumatology Health Professionals October 28 in San Diego.
Researchers note that the study pinpointed patients with RA, classifying them 6 months later as having reached “low disease activity” or not. The researchers defined “low disease activity” (LDA) as the marked reduction of joint pain, swelling, and other markers of inflammation.
A news release from HSS adds that when comparing patients at 2 years, the researchers observed that participants whose RA had reached a state of low disease activity by 6 months exhibited greater functional ability at 2 years. A related study from this group, HSS reports, also found function to be even greater at 2 years in patients who had reached full remission.
Using data from the Canadian early ArThritis Cohort (CATCH), Vivian Bykerk MD, HSS, and Pooneh Akhavan, MD, FRCP(C), identified 833 patients with early RA who had been followed for 2 years. The researchers assessed the LDA at 6 months on the level disability at 2 years, using the health assessment questionnaire (HAQ) disability index. The HAQ is designed to gauge the difficulty that a patient has in performing basic activities, including walking, bathing, eating, and dressing. The results suggest that achieving early LDA at 6 months was a significant, independent predictor of lower disability at 2 years. The researchers note that a total of 56% of the patients achieved a LDA at 6 months.
Bykerk rearticulates the findings, explaining, “It turns out that at 2 years into the study, patients who got their disease under control sooner had better function than those who did not.”
According to the study, patient age and sex were also key predictors of disability and patients with fibromyalgia at baseline also had more disability. These findings, Bykerk says, indicate patients should meet with their arthritis specialists often in the early phases of RA in order to allow them to assess how the patients are responding to treatment.