THU0620 Gender, Disease Activity, Anxiety and Depression Levels Are Related To The Levels of Fears of Patients with Rheumatoid Arthritis or Axial Spondyloarthritis: A Cross-Sectional Study of 672 Patients
Authors: L. Gossec, P. Chauvin, C. Hudry, M. Poussière, T. de Chalus, V. Saulot, F. Russo-Marie, J.M. Joubert, A. Saraux, F. Berenbaum
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Patients (pts) with rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) have personal fears related to their disease which can impact therapeutic strategy.<sup>1</sup> We previously reported high levels of fears in RA and axSpA pts in a French multicenter survey.<sup>2</sup> <h3>Objectives</h3> To identify factors associated with high levels of fears in RA and axSpA pts. <h3>Methods</h3> This national cross-sectional study was performed in 2014–2015 in France.<sup>2</sup> Rheumatologists recruited 6–20 pts with RA (ACR/EULAR criteria) or axSpA (ASAS criteria). Pts self-completed the "Opinions and fears of pts with chronic inflammatory rheumatism" (QOC-RIC) questionnaire<sup>2</sup> comprising 44 items including 23 questions on pt fears; each scored between 0–10 (10 = "totally agree"). Eighteen questions related to progression and consequences of the disease and 5 questions related to treatment. For each fear, descriptive analysis explored the percentage of pts with scores ≥7/10. A cluster analysis was run on the whole population to identify homogeneous groups (clusters) of pts according to their fears and beliefs (hierarchical ascendant classification). A multivariate multinomial logistic regression model using backward selection and multiple missing data imputation explored the variables (eg. epidemiological, socioeconomic, clinical) with p&lt;0.05 on differences between clusters. <h3>Results</h3> Overall, 672 pts recruited by 100 rheumatologists were analyzed (432 RA, 240 axSpA). For RA and axSpA pts respectively, 74.0% and 45.2% were female, average age was 58.3 (±13.1) and 47.0 (±13.2) years, and 77.3% and 72.7% were treated with biologics. Mean Disease Activity Score 28 (DAS28[ESR]) in RA pts was 2.64 (±1.24) and mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in axSpA pts was 3.3 (±2.2). Four pt clusters were identified corresponding to very high (31.6%), high (21.9%), moderate (32.7%) or low (13.8%) levels of fears (Figure). Variables related to the highest fear cluster were gender (female vs male; OR=2.38, p=0.013), high Pt Global Assessment of Disease Activity (PtGA [VAS]; &gt;60 vs ≤30; OR=3.03, p=0.029), anxiety (HADS, anxiety score; &gt;10 vs &lt;8; OR=4.55, p&lt;0.001) and depression (HADS, depression score; ≥8 vs &lt;8; OR=3.23, p=0.011). Socioprofessional and family status did not have an associated p value &lt;0.05 between populations with lowest and highest fears. <h3>Conclusions</h3> Pts with the highest fears were most likely to be women with higher PtGA and anxiety/depression scores. Fears may reflect overall psychological distress in this population of pts and interventions to decrease these fears should be further assessed. <h3>References</h3> Nestoriuc Y. Arthritis Care Res 2010;62:791–9; Gossec L. Ann Rheum Dis 2015;74(S2):323 <h3>Acknowledgement</h3> The authors acknowledge Costello Medical Consulting, funded by UCB Pharma, for writing and editorial assistance. This study was funded by UCB Pharma and Arthritis Foundation Olivier Courtin. <h3>Disclosure of Interest</h3> L. Gossec: None declared, P. Chauvin: None declared, C. Hudry: None declared, M. Poussière: None declared, T. de Chalus Employee of: UCB Pharma, V. Saulot: None declared, F. Russo-Marie: None declared, J. Joubert Employee of: UCB Pharma, A. Saraux: None declared, F. Berenbaum: None declared