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The results of a study published in the December issue of the Annals of the Rheumatic Diseases suggest that the health status of patients with rheumatoid arthritis improved between 1994 and 2004. Investigators suggest this is most likely the result of better and more aggressive treatments.
"Over the last decade, major changes have occurred in the provision of health care for patients with rheumatoid arthritis," Dr. Till Uhlig, of Diakonhjemmet Hospital in Oslo, and colleagues write. "Growing attention has been paid to improved management strategies with early and more aggressive treatment, which reflects important advances in the treatment along with access to more effective and specific drugs for patients with rheumatoid arthritis."
The researchers examined possible changes in health status and levels of self-reported health from 1994 to 2004 among patients in the Oslo Rheumatoid Arthritis Register.
Postal questionnaires were sent to all patients in 1994, 1996, 2001 and 2004. Included were the Modified Health Assessment Questionnaire, the Arthritis Impact Measurement Scales 2, visual analog scales and others to assess pain, fatigue and disease activity.
An average of 924 patients between the ages of 20 and 79 years responded each year. At baseline, the mean patient age was 60.6 years, and the mean disease duration was 12.6 years.
The authors used a mixed model approach for longitudinal analysis adjusting for age, gender, comorbidity, disease duration and type of treatment.
Overall, the health status in the rheumatoid arthritis patients consistently improved in all dimensions of health evaluated over the 10-year period.
Improvements were significant for the physical dimension, global health, and pain. Both the year of disease onset and year of examination had an effect on key measures of longitudinal health status outcome, the researchers add.
"This study demonstrates consistent improvement in rheumatoid arthritis health status in the population from 1994 to 2004, and also better health status outcomes in patients with more recent disease onset," Dr. Uhlig and colleagues conclude.
The improvements in rheumatoid arthritis patients over time may be attributed to better treatment. "Our findings thus support the importance of improved management strategies in population settings where the treatment of rheumatoid arthritis has not yet been given a sufficiently high priority."
Ann Rheum Dis 2008;67:1710-1715.
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