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Elvira Manzano, 3 days ago
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Depression, anxiety negatively predict joint remission in RA, PsA

19 Aug 2017

Depression and anxiety appear to reduce the likelihood of achieving joint remission in rheumatoid arthritis (RA) and, partly, in psoriatic arthritis (PsA), according to a study.

Researchers examined 1,326 patients with RA and 728 patients with PsA from the prospective observational Norwegian Disease-Modifying Anti-Rheumatic Drug study. All patients had initiated first-time tumour necrosis factor inhibitors (TNFi) or methotrexate (MTX).

Prespecified logistic and multiple linear regression models were used to estimate the predictive value of depression/anxiety on remission and test the associations between baseline depression/anxiety and the components of the remission criteria.

The number of patients with depression/anxiety was 573 in the RA group (mean age 53.5 years; 75.1 percent) and 326 in the PsA group (mean age 46.9 years; 59.7 percent).

Baseline depression/anxiety negatively predicted 28-joint Disease Activity Score <2.6, Simplified Disease Activity Index ≤3.3, Clinical Disease Activity Index ≤2.8, ACR/EULAR Boolean and Disease Activity Index for Psoriatic Arthritis ≤4 remission after 3 and 6 months of treatment in RA. Corresponding findings in PsA also showed consistently lower point estimates but did not reach significance for all the analyses.

Moreover, baseline depression/anxiety correlated with increased patient’s and evaluator’s global assessment, tender joint count and joint pain in RA at follow-up, as well as with increased patient’s and evaluator’s global assessment in PsA, but not with swollen joint count and acute phase reactants.

The findings were robust across different depression/anxiety and remission criteria, as well as in subgroup analyses of TNFi- and MTX-treated patients.

Psychiatric conditions such as depression and anxiety should be taken into account in individual RA or PsA patients when making a shared decision on a treatment target, researchers said.

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Most Read Articles
Elvira Manzano, 3 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
9 hours ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.
Tristan Manalac, 11 hours ago
Statin use, particularly in smokers, obese patients and nondiabetics, has a strong and dose-dependent association with decreasing risk of pancreatic ductal adenocarcinoma (PDAC), according to a new study.