Determinants of physical function, as measured using PROMIS PF-10a, in patients with rheumatoid arthritis: results from the international COVID-19 Vaccination in Autoimmune Diseases (COVAD) study
Authors: Ali Saadia Sasha , Demetriou Christiana , Parodis Ioannis , Tan Ai Lyn , Edgar Gracia-Ramos Abraham , Joshi Mrudula , Caballero-Uribe Carlo V , Saha Sreoshy , Lilleker James B , Nune Arvind , Pauling John D , Wincup Chris , Jagtap Kshitij , Dey Dzifa , Milchert Marcin , Distler Oliver , Chinoy Hector , Agarwal Vikas , Gupta Latika , Nikiphorou Elena ,   COVAD Study Group, Kadam Esha , Yaadav Praggya , Day Jessica , Shinjo Samuel Katsuyuki , Ziade Nelly , Velikova Tsvetelina , Cavagna Lorenzo , Kuwana Masataka , Knitza Johannes , Chen Yi Ming , Makol Ashima , Agarwal Vishwesh , Patel Aarat , Barman Bhupen , Tehozol Erick Adrian Zamora , Serrano Jorge Rojas , Torre Ignacio García-De La , Colunga Pedraza Iris J , Merayo-Chalico Javier , Chibuzo Okwara Celestine , Katchamart Wanruchada , Goo Phonpen Akawatcharangura , Shumnalieva Russka , Hoff Leonardo Santos , El Kibbi Lina , Halabi Hussein , Vaidya Binit , Shaharir Syahrul Sazliyana , Tanveer Hasan A T M , Gutiérrez Carlos Enrique Toro , Lilleker James B , Salim Babur , Gheita Tamer , Chatterjee Tulika , Saavedra Miguel A , Kardes Sinan , Andreoli Laura , Lini Daniele , Screiber Karen , Vince Melinda Nagy , Singh Yogesh Preet , Ranjan Rajiv , Jain Avinash , Pandya Sapan C , Pilania Rakesh Kumar , Sharma Aman , Manesh Manoj M , Gupta Vikas , Kavadichanda Chengappa G , Patro Pradeepta Sekhar , Ajmani Sajal , Phatak Sanat , Goswami Rudra Prosad , Chowdhury Abhra Chandra , Mathew Ashish Jacob , Shenoy Padnamabha , Asranna Ajay , Bommakanti Keerthi Talari , Shukla Anuj , Pande Arunkumar R , Chandwar Kunal , Ghodke Akanksha , Boro Hiya , Fazal Zoha Zahid , Cansu Döndü Üsküdar , Yıldırım Reşit , Gasparyan Armen Yuri , Del Papa Nicoletta , Sambataro Gianluca , Fabiola Atzeni , Govoni Marcello , Parisi Simone , Bocci Elena Bartoloni , Sebastiani Gian Domenico , Fusaro Enrico , Sebastiani Marco , Quartuccio Luca , Franceschini Franco , Sainaghi Pier Paolo , Orsolini Giovanni , De Angelis Rossella , Danielli Maria Giovanna , Venerito Vincenzo , Grignaschi Silvia , Giollo Alessandro , Alunno Alessia , Ioannone Florenzo , Fornaro Marco , Traboco Lisa S , Kusumo Wibowo Suryo Anggoro , Loarce-Martos Jesús , Prieto-González Sergio , Gonzalez Raquel Aranega , Yoshida Akira , Nakashima Ran , Sato Shinji , Kimura Naoki , Kaneko Yuko , Gono Takahisa , Tomaras Stylianos , Proft Fabian Nikolai , Holzer Marie-Therese , Gromova Margarita Aleksandrovna , Aharonov Or , Griger Zoltán , Hmamouchi Ihsane , El Bouchti Imane , Baba Zineb , Giannini Margherita , Maurier François , Campagne Julien , Meyer Alain , Langguth Daman , Limaye Vidya , Needham Merrilee , Srivastav Nilesh , Hudson Marie , Landon-Cardinal Océane , Rojas Zuleta Wilmer Gerardo , Arbeláez Álvaro , Cajas Javier , Pereira Silva José António , Fonseca João Eurico , Zimba Olena , Ima-Edomwonyi Uyi , Dedeke Ibukunoluwa , Airenakho Emorinken , Madu Nwankwo Henry , Yerima Abubakar , Olaosebikan Hakeem , Becky A , Koussougbo Oruma Devi , Palalane Elisa , So Ho , Ugarte-Gil Manuel Francisco , Chinchay Lyn , Bernaola José Proaño , Pimentel Victorio , Fathi Hanan Mohammed , Mohammed Reem Hamdy A , Harifi Ghita , Fuentes-Silva Yurilís , Cabriza Karoll , Losanto Jonathan , Colaman Nelly , Cachafeiro-Vilar Antonio , Bautista Generoso Guerra , Giraldo Ho Enrique Julio , González Raúl , Nunez Lilith Stange , Cristian Vergara M , Báez Jossiell Then , Alonzo Hugo , Santiago Pastelin Carlos Benito , Salinas Rodrigo García , Obiols Alejandro Quiñónez , Chávez Nilmo , Ordóñez Andrea Bran , Argueta Sandra , Reyes Llerena Gil Alberto , Sierra-Zorita Radames , Arrieta Dina , Hidalgo Eduardo Romero , Saenz Ricardo , Idania Escalante M , Morales Roberto , Calapaqui Wendy , Quezada Ivonne , Arredondo Gabriela , Gasparyan Armen Yuri 
Published: December 2024

Abstract

Objectives
Physical function in RA is largely influenced by multiple clinical factors, however, there is a growing body of evidence that psychological state and other comorbidities also play an essential role. Using data obtained in the COVID-19 Vaccination in Autoimmune Diseases study, an international self-reported e-survey, we aimed to explore the predictive ability of sociodemographic and clinical variables on Patient-Reported Outcomes Measurement Information System Physical Function Short Form 10a (PROMIS PF-10a) in RA and to investigate variation in disease activity and functional outcomes based on country-level socio-economic parameters.

Methods
Patient demographics, disease characteristics including current symptom status, functional status and treatment variables, as well as income level of the country of residence, were extracted from survey responses. PROMIS PF-10a scores were compared across country income levels. The influence of extracted variables on reversed PROMIS PF-10a scores were investigated using negative binomial univariable- and multivariable regression.

Results
A total of 1342 RA patients were included in this analysis. In the optimised parsimonious predictive model for reversed PROMIS PF-10a, older age, female gender, disease duration, fatigue and pain levels were independently associated with worse physical function, whereas Asian ethnicity, higher overall physical health ratings, ability to carry out everyday activities and residing in a country with an upper-middle or high-income level were independently associated with better physical function.

Conclusion
Our study highlights that clinical factors remain strong predictors of physical function in RA, irrespective of individual and country-level socio-economic differences. Interestingly, high country-level income was associated with better physical function, irrespective of individual sociodemographic and clinical factors.