Do people with rheumatoid arthritis maintain their physical activity level at treatment onset over the first year of methotrexate therapy?

Objectives. To describe how many people with RA reduce their baseline physical activity level over the first year of MTX treatment, and which factors predict this. Methods. Data came from the Rheumatoid Arthritis Medication Study (RAMS), a prospective cohort of people with early RA starting MTX. Participants reported demographics and completed questionnaires at baseline, and 6 and 12months, including reporting the number of days per week they performed >= 20min of physical activity, coded as none, low (1-3days) or high (4-7days). The physical activity levels of participants over 12months are described. Predictors of stopping physical activity were assessed using multivariable logistic regression. Results. In total, 1468 participants were included [median (interquartile range) age 60 (50, 69) years; 957 (65.2%) women]. At baseline, the physical activity levels of the people with RA were: none = 408 (27.8%), low = 518 (35.3%) and high = 542 (36.9%). Eighty percent of participants maintained some physical activity or began physical activity between assessments (baseline to 6months = 79.3%, 6months to 12months = 80.7%). In total, 24.1% of participants reduced physical activity and 11.3% of participants stopped performing physical activity between baseline and 6months (6months to 12months: 22.6% and 10.2%, respectively). Baseline smoking, higher disability and greater socioeconomic deprivation were associated with stopping physical activity. Conclusion. Many people with early RA were not performing physical activity when starting MTX, or stopped performing physical activity over the first year of treatment. These people may require interventions to stay active. These interventions need to be mindful of socioeconomic barriers to physical activity participation.

Automated summary

The study found that a significant proportion of patients with early RA reduced or stopped their physical activity levels over the first year of MTX treatment. Factors such as smoking, higher disability, and greater socioeconomic deprivation were associated with stopping physical activity.