HealthDay News – Psychosocial factors may be more important than traditional clinical measures in predicting functional disability in the first year after a rheumatoid arthritis (RA) diagnosis, according to a study published online June 24 in Arthritis & Rheumatology.

Caroline Kronisch, MD, from Cantonal Hospital Fribourg in Switzerland, and colleagues used data from a prospective cohort of 578 patients (64.5% female) with newly presenting RA or undifferentiated arthritis to determine baseline predictors of disability (defined as a Health Assessment Questionnaire [HAQ] score of ≥1) at one year.

High Yield Data Summary

  • Functional disability at 1 year after RA diagnosis appears to be predicted by psychosocial factors including depression, anxiety, missed work, and unemployment

The researchers found that 36.7% of patients reported functional disability at one year. 

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Predictors of functional disability at one year were baseline disability (odds ratio [OR], 2.67; 95%confidence interval [CI], 1.98 to 3.59), depression (OR, 2.52; 95%CI, 1.18 to 5.37), anxiety (OR, 2.37; 95% CI, 1.33 to 4.21), being in paid employment with absenteeism during the last week (OR, 1.19; 95%CI, 0.63 to 2.23), not being in paid employment (OR, 2.36; 95%CI, 1.38 to 4.03), and being overweight (OR, 1.61; 95% CI, 1.04 to 2.5).

“In the context of modern early inflammatory arthritis treatment paradigms, predictors of disability at one year appear to be dominated by psychosocial rather than more traditional clinical measures,” conclude the authors.

Summary and Clinical Applicability

Depression, anxiety, missed work, unemployment are predictors of disability at one year. These results suggest that 
early access to nonpharmacologic interventions to address psychosocial factors may prevent the most disability in RA.

Pfizer partially funded this study. Several authors report financial ties to pharmaceutical companies including Pfizer, which partially funded the study.

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Kronisch C, Mclernon DJ, Dale J, et al. Brief Report: Predicting Functional Disability: One-Year Results From the Scottish Early Rheumatoid Arthritis Inception Cohort. Arthritis Rheumatol. 2016;68(7):1596-602.