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Researchers investigated long-term predictors of functional decline in patients with rheumatoid arthritis (RA) who had achieved Health Assessment Questionnaire-Disability Index (HAQ-DI) remission, with a focus on factors associated with preserving functional status over a 10-year period.
Sustained clinical remission and fracture prevention play a pivotal role in preserving long-term functional independence in patients with rheumatoid arthritis.
Researchers investigated long-term predictors of functional decline in patients with rheumatoid arthritis (RA) who had achieved Health Assessment Questionnaire-Disability Index (HAQ-DI) remission, with a focus on factors associated with preserving functional status over a 10-year period.
This retrospective cohort study included patients with RA who achieved baseline HAQ-DI remission. Annual assessments of HAQ-DI and disease activity were performed, while newly developed comorbidities were evaluated using the Rheumatic Disease Comorbidity Index. Patients were categorized according to functional stability or deterioration, and potential predictors of long-term functional decline were examined using univariate and multivariate logistic regression analyses.
Although overall disease activity remained low throughout follow-up, functional deterioration occurred in 26% of patients. Individuals who maintained functional remission exhibited significantly lower average disease activity than those who experienced worsening disability.
Fracture emerged as the most common newly developed comorbidity during follow-up. Multivariate analysis identified higher long-term disease activity and incident fractures as independent predictors of functional decline, with fractures associated with an almost fivefold increase in risk.
The findings demonstrated that maintaining low disease activity alone was insufficient to guarantee long-term preservation of physical function in RA. Sustained clinical remission and effective fracture prevention were independently associated with improved functional outcomes, emphasizing the need for comprehensive management strategies that target both inflammatory control and musculoskeletal health over time.
Clinical Rheumatology
Maintaining clinical remission and preventing fractures are essential for preserving functional status over a 10-year period in patients with rheumatoid arthritis who have achieved Health Assessment Questionnaire-Disability Index remission: a retrospective cohort study
Kensuke Koyama et al.
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