AB0222 Differences of disease impression and treatment expectation in rheumatoid arthritis patients with different disease activity
Authors: E. Torikai, D. Suzuki, M. Suzuki, Y. Matsuyama
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Rheumatoid arthritis (RA) is a systemic chronic arthritic inflammatory disease that affects daily life and work. Therefore, the treatment goals include subjective indicators such as activities of daily living disorder and fatigue as well as objective indicators such as disease activity<sup> (1)</sup>. In recent years, the progress of RA therapy has been remarkable, and many patients have achieved low disease activity (LDA) or remission; however, one-third of the patients still have a high disease activity. Is it right to adapt all patients to the same subjective evaluation goal? <h3>Objectives</h3> We conducted a questionnaire survey in RA patients to evaluate the following factors: 1) RA influence on emotions, 2) RA influence on daily life or work, 3) patient expectations from RA treatment and 5) a comparison of patients' individual assessment of each disease activity. <h3>Methods</h3> We included 289 patients with RA and divided them into two groups based on their disease activity: those achieving LDA or remission (R/L group: n=192) and those with moderate or high disease activity (M/H group: n=97). The mean ages of the R/L and M/H groups were 52.3 (18–81) and 56.7 (25–84) years, respectively. The mean disease duration of the R/L and M/H groups were 4.3 years (2 months – 25 years) and 5.6 years (2 months – 31 years), respectively. The survey comprised 19 questions, which had predefined answers about daily activities, relationship with family and friends, emotional wellbeing, expectation from RA treatment effect, and treatment goal-setting. <h3>Results</h3> For questions regarding daily activities and emotional wellbeing, there were more negative responses from the M/H group than from the R/L group. Daily activity which conclude housework and outdoor activities were more restricted in the M/H group than in the R/L group. Regarding emotional wellbeing, 63% patients in the M/H group and 32% in the R/L group felt that RA was depriving their happiness. Furthermore, 56% patients in the M/H group and 25% in the R/L group were worried about their independence in the future. Conversely, patients in the M/H group exchanged views about RA symptoms with family and friends more frequently than those in the R/L group; they were seeking psychological stabilisation. There were also differences in both the groups' expectation of the treatment effect. The most and the second expected treatment effects in both groups were pain improvement and in the early stage, respectively. The third most expected treatment effect was being able to do their work at home and outside in the R/L group and clinical symptoms improvement in the M/H group. Morning stiffness was more important than arthritis in the R/L group because a higher goal was set. Although it would be desirable for medical professionals to set treatment goals for both groups, this tendency was higher in the M/H group. <h3>Conclusions</h3> The subjective goals in RA treatment vary depending on disease activity. High social goal-setting is important for patients whose disease activity is controlled. For patients with high disease activity, emotional support from their family and friends and setting goals regarding clinical symptoms by medical professionals are important. <h3>Reference</h3> [1] Vibeke Strand, et al. J Rheumatol2015. <h3>Disclosure of Interest</h3> None declared