Effective Treatment for Rapid Improvement of Both Disease Activity and Self-Reported Physical Activity in Early Rheumatoid Arthritis.

Abstract

OBJECTIVE:

To investigate the longitudinal relationship between disease activity and self-reported physical activity (PA) in patients with early rheumatoid arthritis during the first year of treatment with combination therapy.

METHODS:

PA was measured with the Short Questionnaire to Assess Health-Enhancing Physical Activity at baseline, 13 weeks, 26 weeks, and 52 weeks after start of treatment in the context of the Combinatietherapie Bij Reumatoïde Artritis-Light trial. The reported PA classified patients as meeting or not meeting the World Health Organization (WHO) PA guideline (cutoff: 150 minutes of moderate-to-intense activity per week). Other measurements included the Disease Activity Score (DAS). Since both treatment arms showed equal treatment effect, these were analyzed as 1 group with simple before-after analyses and generalized estimating equations (GEE).

RESULTS:

In these analyses, 140 patients (86% of the trial population, 66% women, mean age 52 years) with complete data were included. At entry, 69% of the patients met the WHO PA guideline, increasing to 90% at week 13, and remaining stable at 89% after 1 year (P < 0.001). Mean DAS improved from 4.0 to 1.8 during the first year of treatment (P < 0.001). In GEE analyses, DAS decreases were significantly associated with PA increases (P = 0.008). Patients with clinically relevant responses (expressed as DAS remission, European League Against Rheumatism good response or American College of Rheumatology criteria for 70% improvement response) showed higher PA levels compared to nonresponders, regardless of the definition of response, for both the WHO and Dutch PA guideline.

CONCLUSION:

Early rheumatoid arthritis patients using combination therapy improved both disease activity and PA, a beneficial effect persisting for at least 1 year.

• Authors: Nicole P C Konijn, Lilian H D van Tuyl, Maarten Boers, Debby den Uyl, Marieke M Ter Wee, Pit Kerstens, Alexandre E Voskuyl, Michael Nurmohamed, Dirkjan van Schaardenburg, Willem F Lems
• Journal: Arthritis care & research (Arthritis Care Res (Hoboken)) Vol. 68 Issue 2 Pg. 280-4 (Feb 2016) ISSN: 2151-4658 [Electronic] United States
• PMID: 26214269 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2016, American College of Rheumatology.

Chemical References

• Antirheumatic Agents

Topics

• Adult
• Aged
• Aged, 80 and over
• Antirheumatic Agents (therapeutic use)
• Arthritis, Rheumatoid (therapy)
• Combined Modality Therapy
• Exercise
• Female
• Humans
• Male
• Middle Aged
• Phototherapy
• Self Report
• Young Adult