Depression Affects Remission in Patients With RA or PsA

TOPLINE:

Depression is associated with lower odds of achieving remission in patients with rheumatoid arthritis (RA) or psoriatic arthritis (PsA) over 2 years of follow-up. 

METHODOLOGY:

• Researchers analyzed data from two cohorts in the Netherlands to assess the impact of depression and anxiety on remission in 400 patients with RA and 367 patients with PsA.
• Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS), which included a depression subscale (HADS-D) and an anxiety subscale (HADS-A).
• The HADS was administered every 6 months to patients with RA and every year to those with PsA, with scores > 7 on the HADS-D and HADS-A subscales indicating the respective disorders.
• The primary outcome was the ability to achieve remission, which was defined as a 44-joint Disease Activity Score
• Patients with depression or anxiety, at any timepoint during 2 years of follow-up, were compared with those without depression or anxiety.

TAKEAWAY:

• In patients with RA and PsA, those with depression or anxiety at baseline had lower remission rates at 1 and 2 years of follow-up than in those without.
• After adjusting for anxiety, depression was associated with a lower likelihood of achieving remission in both patients with RA (adjusted odds ratio [aOR], 0.45; 95% CI, 0.25-0.80) and those with PsA (aOR, 0.24; 95% CI, 0.08-0.71).
• After adjusting for depression, anxiety did not show a significant association with achieving remission in patients with RA or PsA.
• Symptoms of depression or anxiety were linked to worse general health and increased tender joint counts and levels of inflammation markers in RA as well as PsA.

IN PRACTICE:

“[The] data underscores the importance of screening for psychological symptoms in patients with RA or PsA,” the authors wrote. “Therefore, proper recognition of depression may improve disease management of patients with RA or PsA. This could potentially result in fewer (unnecessary) treatment alterations and reduced healthcare and societal costs,” they added.

SOURCE:

The study was led by Selinde V.J. Snoeck Henkemans, Erasmus MC, Rotterdam, the Netherlands. It was published online on November 6, 2024, in Rheumatology.

LIMITATIONS:

The study’s inability to demonstrate causality limited the interpretation of the association between depression or anxiety and remission. Confounding factors, such as deformed joints and comorbidities like fibromyalgia, may have influenced the results. Additionally, patient dropout during the 2-year follow-up may have impacted the generalizability of the findings.

DISCLOSURES:

The study was supported by an unrestricted grant from ZonMw, Pfizer, and AbbVie. The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.