Health Assessment Questionnaire Score Is the Best Predictor of 5-Year Quality of Life in Early Rheumatoid Arthritis
JEAN-DAVID COHEN, MAXIME DOUGADOS, PHILIPPE GOUPILLE, ALAIN CANTAGREL, OLIVIER MEYER, JEAN SIBILIA, JEAN-PIERRE DAURÈS, BERNARD COMBE
Objective. To evaluate and determine prognostic factors of 5-year quality of life in patients with early rheumatoid arthritis (RA).
Methods. A cohort of 191 patients with RA and disease duration < 1 year was prospectively followed over 5 years. The outcome measure was quality of life as assessed by the Arthritis Impact Measurement Scales 2 (AIMS2). Univariate analysis, then stepwise multiple logistic regression, was used to find independent baseline prognostic variables.
Results. After accounting for death, loss of followup, and missing data, 158 patients (82.72%) were included in the analysis. The mean AIMS2 physical, symptom, psychological, social interaction, and work scores after 5 years were 1.6 (range 0–6.88), 4.0 (0–10), 3.48 (0–9.22), 4.06 (0–8.69), and 1.87 (0–8.13), respectively. The AIMS2 physical component was significantly correlated with Health Assessment Questionnaire (HAQ) score at 5 years. Logistic regression analysis revealed that the baseline values able to predict the 5-year physical, psychological, symptom, social interaction, and work status were, respectively: HAQ score and erythrocyte sedimentation rate (ESR), body mass index (BMI), HAQ; erosion score and sex, HAQ; ESR and anti-perinuclear antibody; matrix metalloproteinase-3 (MMP3) level, joint space narrowing, and tender joint scores; HAQ score and age.
Conclusion. The multidimensional structure of the AIMS2 allowed us to assess the 5-year health-related quality of life in early RA. Using this instrument as an outcome variable, prognostic factors were selected and varied widely depending on the evaluated domain. The baseline HAQ score was the best predictive factor of 4 of the 5 domains of the AIMS2. (First Release Aug 15 2006; J Rheumatol 2006;33:1936-41)
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From the Department of Immuno-Rhumatologie, CHU Montpellier, Montpellier I University and INSERM U454, Montpellier; Service de Rhumatologie, CHU Cochin, Paris; Service de Rhumatologie, CHU Tours, Tours; Service de Rhumatologie, CHU Rangueil, Toulouse; Service de Rhumatologie, CHU Bichat, Paris; Service de Rhumatologie, CHU Strasbourg; and Institut Universitaire de Recherche Clinique, Montpellier, France.
J-D. Cohen, MD, Immuno-Rhumatologie, CHU Montpellier; M. Dougados, MD, Service de Rhumatologie, CHU Cochin; P. Goupille, MD, Service de Rhumatologie, CHU Tours; A. Cantagrel, MD, Service de Rhumatologie, CHU Rangueil; O. Meyer, MD, Service de Rhumatologie, CHU Bichat; J. Sibilia, MD, Service de Rhumatologie, CHU Strasbourg; J-P. Daurès, MD, PhD, Institut Universitaire de Recherche Clinique, Montpellier; B. Combe, MD, PhD, Immuno-Rhumatologie, CHU Montpellier.
Address reprint requests to Dr. B. Combe, Immuno-Rhumatologie, CHU Lapeyronie, 34295 Montpellier cedex 5, France. E-mail: firstname.lastname@example.org
Accepted for publication May 22, 2006.