Does Clinical Remission Lead to Normalization of EQ-5D in Patients with Rheumatoid Arthritis and Is Selection of Remission Criteria Important?

Objective. To compare health-related quality of life (HRQOL) of patients With rheumatoid arthritis (RA) to that of the general population and to investigate the association with disease activity, focusing oil different clinical remission criteria. Methods. EQ-5D data from 3156 patients with RA from 11 Danish centers were compared with Danish EQ-5D population norms (n = 16,136). The Disease Activity Score (DAS28) and the Clinical Disease Activity Index score (CDAI) were used as definitions of disease activity and clinical remission. The score difference (Delta EQ-5D) was calculated in each patient as the difference from the age and sex-matched general Population and ad Listed for age, marital status, education, body mass index, smoking, exercise habits, disease duration, IgM-rheumatoid factor Status, joint surgery extraarticular features, treatment and comorbidity in Multiple linear regression models. Results. 37% vs 22% fulfilled the DAS28 and CDAI remission criteria, respectively. The Delta EQ-5D values for women/men in clinical remission were DAS28 0.05/0.06 vs CDAI 0.01/0.02: low disease activity: DAS28 0.12/0.13 vs CDAI 0.11/0.14 moderate disease activity: DAS28 0.18/0.20 vs CDAI 0.20/0.23: and high disease activity: DAS28 0.38/0.28 vs CDAI 0.33/0.26. Adjusting for confounders reduced the Delta EQ-5D values between 0 and 0.04 units. Conclusion. Patients with RA had worse EQ-5D scores than the general population. and the difference was strongly associated with disease activity. The EQ-5D score for patients in clinical remission approached that of the general population, suggesting that strict treatment goals are critical in order to achieve near-normal HRQOL in patients with RA. (First Release Jan 15 20 10 J Rheumatol 2010:37:285-90: doi: 10.3899/jrheum.090898)