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Research ArticleArticle

Does Clinical Remission Lead to Normalization of EQ-5D in Patients with Rheumatoid Arthritis and Is Selection of Remission Criteria Important?

LOUISE LINDE, JAN SØRENSEN, MIKKEL ØSTERGAARD, KIM HØRSLEV-PETERSEN and MERETE LUND HETLAND
The Journal of Rheumatology February 2010, 37 (2) 285-290; DOI: https://doi.org/10.3899/jrheum.090898
LOUISE LINDE
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JAN SØRENSEN
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MIKKEL ØSTERGAARD
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KIM HØRSLEV-PETERSEN
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MERETE LUND HETLAND
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    Figure 1

    Sex-stratified EQ-5D scores (A: women; B: men) for the general population and patients with RA grouped according to disease activity using the DAS28 and CDAI criteria.

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    Table 1

    Patient characteristics for all respondents and stratified according to disease activity using the DAS28 and CDAI criteria (n = 3156). Values are median (interquartile range) unless otherwise stated.

    All Patients, RemissionLow Disease ActivityModerate Disease ActivityHigh Disease Activity

    n = 3156
    DAS28, n = 1175CDAI, n = 683DAS28, n = 588CDAI, n = 1351DAS28, n = 1142CDAI, n = 785DAS28, n = 251CDAI, n = 337
    Women, %757167757478807879
    Age, yrs62 (52–70)61 (52–68)61 (51–68)63 (53–71)63 (53–70)61 (52–70)61 (51–69)60 (50–69)59 (51–70)
    Disease duration, yrs7 (3–15)7 (3–14)6 (3–12)8 (3–16)8 (3–16)8 (3–16)7 (2–15)6 (1–15)5 (1–15)
    HAQ score (0–3)0.63 (0.25–1.25)0.25 (0–0.63)0.13 (0–0.50)0.63 (0.25–1.13)0.63 (0.25–1.13)0.88 (0.50–1.38)0.88 (0.50–1.50)1.50 (1.00–2.00)1.40 (0.75–1.88)
    Radiographic erosions, %656358716963636259
    IgM-rheumatoid factor positive, %777673817976767473
    Biological therapy, %201821211920202222
    Use of methotrexate, %727576747470706263
    Glucocorticoid use past month, %211511202024243836
    • DAS28: Disease Activity Score; CDAI: Clinical Disease Activity Index.

    • View popup
    Table 2A

    EQ-5D scores for the female general population (n = 8543) and RA patients (n = 2183) stratified according to age and disease activity using the DAS28 and CDAI criteria. Data are mean (standard deviation).

    Age, yrsNormRemissionLow Disease ActivityModerate Disease ActivityHigh Disease Activity
    nnDAS28nCDAInDAS28nCDAInDAS28nCDAInDAS28nCDAI
    <4540080.90 (0.14)1270.84 (0.11)860.86 (0.10)580.75 (0.10)1260.77 (0.10)1350.68 (0.13)940.67 (0.14)320.46 (0.27)460.51 (0.25)
    45–6430620.86 (0.17)3890.80 (0.11)2120.83 (0.11)2000.74 (0.12)4520.74 (0.12)3890.65 (0.15)2860.63 (0.15)830.47 (0.20)1110.52 (0.20)
    65–9314730.80 (0.21)2580.78 (0.16)1400.84 (0.13)1600.69 (0.15)3460.71 (0.15)2900.67 (0.16)1980.65 (0.17)620.49 (0.24)860.53 (0.23)
    Total85430.87 (0.17)7740.80 (0.13)4380.84 (0.11)4180.72 (0.13)9240.73 (0.13)8140.66 (0.15)5780.65 (0.16)1770.47 (0.23)2430.52 (0.22)
    • View popup
    Table 2B

    EQ-5D scores for the male general population (n = 7593) and RA patients (n = 729) stratified according to disease activity using the DAS28 and CDAI criteria. Data are mean (standard deviation).

    Age, yrsNormRemissionLow Disease ActivityModerate Disease ActivityHigh Disease Activity
    nnDAS28nCDAInDAS28nCDAInDAS28nCDAInDAS28nCDAI
    <4533700.93 (0.12)270.86 (0.10)170.87 (0.11)80.77 (0.06)250.80 (0.08)230.69 (0.17)140.64 (0.20)40.51 (0.17)60.60 (0.20)
    45–6429140.89 (0.15)1560.82 (0.12)1040.86 (0.11)480.72 (0.12)1280.73 (0.11)1000.66 (0.17)650.63 (0.18)260.62 (0.14)330.62 (0.14)
    65–8913090.85 (0.18)1450.81 (0.13)970.85 (0.11)610.75 (0.15)1500.73 (0.14)1060.68 (0.16)620.66 (0.17)250.59 (0.20)280.62 (0.22)
    Total75930.90 (0.15)3280.82 (0.12)2180.86 (0.11)1170.74 (0.13)3030.74 (0.13)2290.68 (0.16)1410.64 (0.18)550.60 (0.17)670.62 (0.18)
    • View popup
    Table 3

    EQ-5D score differences (∆EQ-5D) between the general population and RA patients [(norm)–(patients)] (n = 2912). Values are mean (standard deviation). EQ-5D norm values used in the calculation of the ∆EQ-5D may differ from the norm values observed in Table 2A and 2B because of the different age distribution in the norm and patient sample. This may lead to slightly different ΔEQ-5D values than could be expected from Table 2A and 2B.

    WomenMen
    nDAS28nCDAInDAS28nCDAI
    Remission7740.05 (0.13)*4380.01 (0.12) NS3280.06 (0.12)*2180.02 (0.11)*
    Low4180.12 (0.13)*9240.11 (0.13)*1170.13 (0.13)*3030.14 (0.11)*
    Moderate8140.18 (0.15)*5780.20 (0.16)*2290.20 (0.17)*1410.23 (0.18)*
    High1770.38 (0.23)*2430.33 (0.22)*550.28 (0.17)*670.26 (0.18)*
    • ↵* Significant differences (one sample t test) between the general population and RA patients.

    • View popup
    Table 4

    Regression model estimates illustrating the association of disease activity with EQ-5D score differences (∆EQ-5D) between the general population and patients with RA (n = 2912). Estimates were adjusted for age, marital status, education level, body mass index, exercise, smoking status, disease duration, extraarticular features, joint surgery, IgM-rheumatoid factor status, comorbidities, and treatment with methotrexate, biological antirheumatic drugs and glucocorticoid.

    Women, n = 2183Men, n = 729
    DAS28CDAIDAS28CDAI
    RemissionReferenceReferenceReferenceReference
    Low0.07 (0.05–0.09)0.09 (0.07–0.11)0.07 (0.04–0.10)0.11 (0.09–0.13)
    Moderate0.12 (0.11–0.13)0.17 (0.15–0.18)0.13 (0.11–0.16)0.20 (0.17–0.22)
    High0.29 (0.27–0.32)0.28 (0.26–0.30)0.20 (0.16–0.24)0.22 (0.18–0.25)
    R20.350.350.280.33
    • All estimates were statistically significant at the 0.001 level.

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1 Feb 2010
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Does Clinical Remission Lead to Normalization of EQ-5D in Patients with Rheumatoid Arthritis and Is Selection of Remission Criteria Important?
LOUISE LINDE, JAN SØRENSEN, MIKKEL ØSTERGAARD, KIM HØRSLEV-PETERSEN, MERETE LUND HETLAND
The Journal of Rheumatology Feb 2010, 37 (2) 285-290; DOI: 10.3899/jrheum.090898

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Does Clinical Remission Lead to Normalization of EQ-5D in Patients with Rheumatoid Arthritis and Is Selection of Remission Criteria Important?
LOUISE LINDE, JAN SØRENSEN, MIKKEL ØSTERGAARD, KIM HØRSLEV-PETERSEN, MERETE LUND HETLAND
The Journal of Rheumatology Feb 2010, 37 (2) 285-290; DOI: 10.3899/jrheum.090898
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