Abs1160 Disability as a Major Determinant of Quality of Life in Rheumatoid Arthritis: an Observational, Cross-sectional Analysis From the Real Study
Year: 2025
Type: conference-abstract
Abstract: Background: Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease that significantly impacts health-related quality of life (HRQoL) [1]. However, the relative strength of different predictors associated with poor HRQoL remains unclear [2]. Objectives: This study aimed to evaluate the most relevant clinical characteristics related to poor HRQoL in patients with long-standing RA under real-life conditions. Methods: This observational, cross-sectional analysis was derived from the multicentric REAL study [3], which enrolled participants meeting the 2010 ACR-EULAR criteria [4] for RA, from 11 public rheumatology centers in Brazil. HRQoL was assessed using the 12-item Short-Form Health Survey (SF-12) for physical and mental scores. Disability as assessed by the Health Assessment Questionnaire-Disability Index (HAQ-DI) along with others clinical-epidemiological characteristics were evaluated as potential predictors of HRQoL. Data were analyzed using bivariate tests (Student's t-test and Pearson's correlation) and multiple linear regression models. The standardized β-coefficients (zβ) of linear regression were used to assess the relative strength of several selected predictors in the multivariate model. The significance level (α) was set at 0.05. Results: A total of 1,079 participants were included, whose general characteristics are displayed in Table 1. In bivariate analysis, biological sex, race, current smoking, regular physical activities, socioeconomic status, erosive disease, corticosteroid and biological disease-modifying antirheumatic drug (bDMARD) use, fibromyalgia, other comorbidities, age, disease duration, body mass index (BMI), joint pain, C-reactive protein, HAQ-DI score and the Simplified Disease Activity Index (SDAI) were significantly associated with SF-12 physical and/or mental health scores (Table 2). In multivariate analysis, the following characteristics remained independently associated with SF12 physical score: non-white race (β [95%CI] = -0.97 [-1.80,-0.14]; zβ = -0.71; p=0.022), practice of regular physical activities (β = 0.56 [0.04, 1.09]; zβ = -0.07; p=0.036) and HAQ-DI score (β = -3.92 [-4.56, -3.28]; zβ = -0.44; p < 0.001); whereas for SF-12 mental the remain independent predictors were: female biological sex (β= -3.91 [-6.36, -1.46]; zβ = -0.10; p=0.002), non-white race (β = 3.32 [1.79, 4.84]; zβ = 0.13; p < 0.001), current smoking (β = -4.95 [7.42, -2.48]; zβ = -0.12; p < 0.001), fibromyalgia (β = -5.52 [-7.76, -3.26]; zβ = -0.15; p < 0.001), SDAI score (β = -0.91 [-0.17, -0.02]; zβ = -0.09; p=0.018) and HAQ-DI score (β = -5.00 [-6.17, -3.83]; zβ = -0.31; p < 0.001). Conclusion: Physical disability was the strongest determinant of poorer HRQoL concerning both physical and mental domains among participants with long-standing RA under real-life conditions. Other relevant, independent predictors for poorer HRQoL were non-white race, female biological sex, lack of regular physical activities, current smoking, fibromyalgia and higher inflammatory disease activity. Strategies to reduce physical disability are advisable to preserve HRQoL in individuals with RA. REFERENCES: [1] Haroon N, Aggarwal A, Lawrence A, Agarwal V, Misra R. Impact of rheumatoid arthritis on quality of life. Mod Rheumatol . 2007;17(4):290-295. doi:10.1007/s10165-007-0604-. [2] Linde L, Sørensen J, Østergaard M, et al. What Factors Influence the Health Status of Patients with Rheumatoid Arthritis Measured by the SF-12v2 Health Survey and the Health Assessment Questionnaire? J Rheumatol . 2009;36(10):2183-2189. doi:10.3899/JRHEUM.090134. [3] Castelar-Pinheiro GR, Vargas-Santos AB, Albuquerque C, et al. ARTRITE REUMATOIDE NO BRASIL - ESTUDO REAL - UMA COORTE PROSPECTIVA NACIONALMENTE REPRESENTATIVA. Rev Bras Reumatol . 2017;57:S379. doi:10.1016/j.rbr.2017.07.534. [4] Kay J, Upchurch KS. ACR/EULAR 2010 rheumatoid arthritis classification criteria. Rheumatology . 2012;51(suppl 6):vi5-vi9. doi:10.1093/rheumatology/kes. Acknowledgements: NIL . Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.
Source: Annals of the Rheumatic Diseases
Authors: L. Shintaku Sabanai, C. Albuquerque, A.P. Gomides, R.D. Neubarth Giorgi, L. Pereira, S. Radominski, I. Alves Pereira, M.F.B. de Resende Guimarães, A. Pugliesi, P. Louzada, M.D.F. Sauma, K. Rossi Bonfiglioli, C.V. Brenol, L. Mota, G. Castelar-Pinheiro
Institutions: Universidade de Brasília, University Center of Brasília, Hospital do Servidor Público Estadual, Universidade do Estado do Rio de Janeiro, Universidade Federal do Paraná, Universidade do Sul de Santa Catarina, Universidade Federal de Minas Gerais, Universidade Estadual de Campinas (UNICAMP), Universidade de São Paulo, Universidade Federal do Pará, Universidade Federal do Rio Grande do Sul
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,870
OpenAlex ID: W4411430786