Faith Matcham1, Rebecca Davies2,3, Matthew Hotopf1,4, Kimme L Hyrich2,3, Sam Norton5,6, Sophia Steer6, James Galloway6. 1. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 2. Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK. 3. NIHR Manchester Biomedical Research Centre, Central Manchester Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK. 4. South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK. 5. Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, UK. 6. Department of Academic Rheumatology, King's College London, London, UK.
Abstract
Objective: To investigate the relationship between depressive symptoms and treatment response and disease activity in RA over a 1-year follow-up. Methods: Data from the British Society for Rheumatology Biologics Register were used, representing 18 421 RA patients receiving biologic treatment. Depressive symptoms were identified through one of three assessments: reporting a history of depression, the Medical Outcomes Survey 36-item Short Form or the EuroQol five-dimension scale. Logistic regression analyses examined the relationship between baseline depressive symptoms and odds of good treatment response by 1 year. Multilevel models addressed the association between baseline depressive symptoms and disease activity outcomes over 1-year follow-up, adjusting for age, gender, disease duration, comorbidities and baseline disease activity and physical disability. Results: Depression symptoms at biologic treatment initiation were associated with 20-40% reduced odds of achieving a good treatment response at 1 year. Depressive symptoms at baseline also associated with reduced improvement in disease activity over the course of follow-up. Patients with a history of depression or reporting symptoms of depression according to the EuroQol five-dimension scale showed reduced improvement in tender and swollen joints, patient global assessment and ESR over 1-year follow-up. Patients with depression symptoms according to the 36-item Short Form showed reduced improvement in tender and swollen joints, but not ESR or patient global assessment. Conclusion: Experiencing symptoms of depression at the start of biologics treatment may reduce the odds of achieving a good treatment response, and reduce improvement in disease activity over time. Depression should be managed as part of routine clinical care to optimize treatment outcomes.
Objective: To investigate the relationship between depressive symptoms and treatment response and disease activity in RA over a 1-year follow-up. Methods: Data from the British Society for Rheumatology Biologics Register were used, representing 18 421 RApatients receiving biologic treatment. Depressive symptoms were identified through one of three assessments: reporting a history of depression, the Medical Outcomes Survey 36-item Short Form or the EuroQol five-dimension scale. Logistic regression analyses examined the relationship between baseline depressive symptoms and odds of good treatment response by 1 year. Multilevel models addressed the association between baseline depressive symptoms and disease activity outcomes over 1-year follow-up, adjusting for age, gender, disease duration, comorbidities and baseline disease activity and physical disability. Results:Depression symptoms at biologic treatment initiation were associated with 20-40% reduced odds of achieving a good treatment response at 1 year. Depressive symptoms at baseline also associated with reduced improvement in disease activity over the course of follow-up. Patients with a history of depression or reporting symptoms of depression according to the EuroQol five-dimension scale showed reduced improvement in tender and swollen joints, patient global assessment and ESR over 1-year follow-up. Patients with depression symptoms according to the 36-item Short Form showed reduced improvement in tender and swollen joints, but not ESR or patient global assessment. Conclusion: Experiencing symptoms of depression at the start of biologics treatment may reduce the odds of achieving a good treatment response, and reduce improvement in disease activity over time. Depression should be managed as part of routine clinical care to optimize treatment outcomes.
Authors: Leticia Leon; Marta Redondo; Antonio Fernández-Nebro; Susana Gómez; Estíbaliz Loza; María Montoro; Rosario Garcia-Vicuña; María Galindo Journal: Rheumatol Int Date: 2018-05-28 Impact factor: 2.631
Authors: Leeanne Nicklas; Mairi Albiston; Martin Dunbar; Alan Gillies; Jennifer Hislop; Helen Moffat; Judy Thomson Journal: BMC Health Serv Res Date: 2022-09-07 Impact factor: 2.908
Authors: Fernando Henrique Azevedo Lopes; Max Victor Carioca Freitas; Veralice Meireles Sales de Bruin; Pedro Felipe Carvalhedo de Bruin Journal: Adv Rheumatol Date: 2021-03-16
Authors: Gary J Macfarlane; Rosemary J Hollick; LaKrista Morton; Maureen Heddle; Eva-Maria Bachmair; R Stuart Anderson; Daniel Whibley; Karen Forrest Keenan; Peter Murchie; Kevin Stelfox; Marcus J Beasley; Gareth T Jones Journal: Rheumatology (Oxford) Date: 2021-10-09 Impact factor: 7.580
Authors: Katie Bechman; Fang En Sin; Fowzia Ibrahim; Sam Norton; Faith Matcham; David Lloyd Scott; Andrew Cope; James Galloway Journal: RMD Open Date: 2018-05-17
Authors: Margarida Figueiredo-Braga; Caleb Cornaby; Alice Cortez; Miguel Bernardes; Georgina Terroso; Marta Figueiredo; Cristina Dos Santos Mesquita; Lúcia Costa; Brian D Poole Journal: J Immunol Res Date: 2018-07-17 Impact factor: 4.818