POS0475 ULTRASOUND EVALUATION CONTRASTS CLINICAL DISEASE ACTIVITY EVALUATION IN RHEUMATOID ARTHRITIS PATIENTS WITH CONCOMITANT ANXIETY OR DEPRESSION
Authors: B. Michelsen, J. Sexton, T. K. Kvien, S. Aarrestad Provan, H. B. Hammer
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> As anxious or depressed patients may have higher disease activity than patients without anxiety or depression as measured by clinical composite scores of disease activity<sup>1</sup>, there is a need to investigate whether such differences are also reflected in imaging modalities, such as ultrasound (US). <h3>Objectives:</h3> To compare disease activity as assessed by US between rheumatoid arthritis (RA) patients with and without anxiety or depression, and to compare clinical disease activity and sociodemographic measures between these patient groups. <h3>Methods:</h3> Anxious or depressed patients were identified by EuroQoL-5D-3L question "I am not/moderately/extremely anxious or depressed." US assessments of 36 joints and 4 tendons were performed and power Doppler (PD) and grey scale (GS) sum scores calculated (both range 0-120). Comparisons between anxious/depressed and not anxious/depressed patients were performed in unadjusted analyses, adjusted logistic regression and sensitivity analyses. <h3>Results:</h3> A total of 201 RA patients starting biologic disease-modifying antirheumatic drugs were included (82% women, mean age 52 years, disease duration 10 years), whereof 109 patients (54.2%) were moderately or extremely anxious/depressed. Median (IQR) PD (13 (4, 21) vs. 10 (3, 20), p=0.53) and GS (28 (18, 42) vs. 25 (14, 41), p=0.51) sum scores were similar between anxious/depressed and not anxious/depressed patients, respectively, whereas composite scores of disease activity were significantly worse in the anxious/depressed patients (p&lt;0.001), as were patient-reported outcomes, ESR, CRP and plasma calprotectin (all p≤0.02, Table 1). Sensitivity analyses confirmed these findings, except for CRP. According to clinical composite scores, significantly more patients with anxiety/depression were in a state of high disease activity (p&lt;0.001, Figure 1). Self-reported economy and sleep difficulties were also worse in the anxious/depressed patients and a higher proportion were not working (all p&lt;0.001). <h3>Conclusion:</h3> This study highlights the negative impact of anxiety and depression on RA patients in standard care, and underscores the challenges in disease activity assessment. US examination may be a valuable objective tool in the evaluation of these patients. <h3>REFERENCES:</h3> [1] Michelsen et al. Ann Rheum Dis 2017;76:1906-10 <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Brigitte Michelsen Speaker's fee from Novartis, Research grant from Novartis paid to employer, Joe Sexton: None declared, Tore K. Kvien Speakers bureau from Grünenthal, Janssen, Sandoz, Consulting fees from AbbVie, Gilead, Janssen, Novartis, Pfizer, Sandoz and UCB, Received research funding to Diakonhjemmet Hospital from AbbVie, BMS, Galapagos, Novartis, Pfizer and UCB, Sella Aarrestad Provan Consulting fees from Pfizer and Boehringer Ingelheim, Hilde Berner Hammer Honoraria for lectures from AbbVie, Novartis and UCB, Advisory board from AbbVie and Novartis.