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Functional capacity in rheumatoid arthritis patients: comparison between Spanish and Brazilian sample

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Abstract

The main objective of this study is to compare Spanish and Brazilian self-reported health-related functional capacity in patients with rheumatoid arthritis (RA). 197 patients diagnosed with RA were studied in Spain (n = 127) and Brazil (n = 70). Pain (Visual analog scale) and functional capacity (Health Assessment Questionnaire/HAQ) were assessed. Patients were questioned about regular exercise practice. Comparisons between groups were performed with Chi-square tests and Student t test. Pearson’s correlation coefficient and linear regression models were used to analyze the associations. Brazilian patients were younger (p = 0.013), had worse levels of pain (p = 0.001) and a trend to experience worse functional capacity (p = 0.057) than Spanish ones. Spanish RA patients had higher body mass index (BMI) (p = 0.019) and longer disease duration (p = 0.001). Also, a higher percentage of subjects with RA from the Spanish cohort had been elected to take early retirement when compared with Brazilian patients (p = 0.010). Spanish RA patients had received more drugs than Brazilians (oral corticosteroids p = 0.010, Leflunomide p = 0.023, Methotrexate p = 0.072, non-steroidal anti-inflammatory drugs p = 0.064, biologic therapies p = 0.001). The functional capacity (HAQ) was correlated with age (p = 0.001), disease duration (p = 0.001), age at diagnosis (p = 0.001), pain (p = 0.001) and BMI (p = 0.001) in Spanish patients. In Brazilian, these correlations were only found with disease duration (p = 0.004) and pain (p = 0.001). In conclusion, our data suggest a better management of RA in Spanish when compared with Brazilians. Even with less pain and functional capacity, they receive more drug treatment and a higher percentage of them are retired early.

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References

  1. Akbulut Aktekin L, Eser F, Malhan S, Oksüz E, Keskin D, Bodur H (2009) A comparison of four different HRQoL generic questionnaire in five different patient groups. Rheumatol Int (epub ahead of print)

  2. Laas K, Roine R, Räsänen P, Sintonen H, Leirisalo-Repo M, HUS QoL Study Group (2009) Health-related quality of life in patients with common rheumatic diseases referred to a university clinic. Rheumatol Int 29:267–273

    Article  PubMed  Google Scholar 

  3. Tander B, Cengiz K, Alayli G, Ilhanli I, Canbaz S, Canturk F (2008) A comparative evaluation of health related quality of life and depression in patients with fibromyalgia syndrome and rheumatoid arthritis. Rheumatol Int 28:859–865

    Article  PubMed  Google Scholar 

  4. Louzada-Junior P, Souza BDB, Toledo RA, Ciconelli RM (2007) Análise descritiva das características demográficas e clínicas de pacientes com artrite reumatóide no Estado de São Paulo-Brasil. Rev Bras Reumatol 47:84–90

    Article  Google Scholar 

  5. Howe HS, Zhao L, Song YW, Springer L, Edmonds J, Gu J et al (2007) Seronegative spondyloarthropathy-studies from the Asia Pacific region. Ann Acad Med Singap 36:135–141

    PubMed  Google Scholar 

  6. Celia D, Nowinsky CJ (2002) Measuring quality of life in chronic illness: the functional assessment of chronic illness therapy measurement system. Arch Phys Med Rehabil 83:10–17

    Article  Google Scholar 

  7. Whalley D, McKenna SP, de Jong Z, van der Heijde D (1997) Quality of life in rheumatoid arthritis. Br J Rheumatol 36:884–888

    Article  CAS  PubMed  Google Scholar 

  8. Mason JH, Weener JL, Gertman PM, Meenan RF (1983) Health status in chronic disease: a comparative study of rheumatoid arthritis. J Rheumatol 10:763–768

    CAS  PubMed  Google Scholar 

  9. Laas K, Peltomaa R, Puolakka K, Kautiainen H, Leirisalo-Repo M (2009) Early improvement of health-related quality of life during treatment with etanercept and adalimumab in patients with rheumatoid arthritis in routine practice. Clin Exp Rheumatol 27:315–320

    CAS  PubMed  Google Scholar 

  10. Singh JA, Strand V (2009) Spondyloarthritis is associated with poor function and physical health-related quality of life. J Rheumatol 36:1012–1020

    Article  PubMed  Google Scholar 

  11. Torigoe DY, Laurindo IMM (2006) Artrite reumatóide e doenças cardiovasculares. Rev Bras Reumatol 46:60–66

    Article  Google Scholar 

  12. Carvalho JAM, Garcia RA (2003) O envelhecimento da população brasileira: um enfoque demográfico. Cad Saude Publica 19:725–733

    PubMed  Google Scholar 

  13. Veras R (2009) Population aging today: demands, challenges and innovations. Rev Saude Publica 43:548–554

    PubMed  Google Scholar 

  14. DC C (1994) Centers for Diseases Control and Prevention. Arthritis prevalence and activity limitations, United States, 1990. MMWR Morb Mortal Wkly Rep 43:433–438

    Google Scholar 

  15. Senna ER, De Barros AL, Silva EO, Costa IF, Pereira LV, Ciconelli RM et al (2004) Prevalence of rheumatic diseases in Brazil: a study using the COPCORD approach. J Rheumatol 31:594–597

    PubMed  Google Scholar 

  16. Chermont GC, Kowalski SC, Ciconelli RM, Ferraz MB (2008) Resource utilization and the cost of rheumatoid arthritis in Brazil. Clin Exp Rheumatol 26:24–31

    CAS  PubMed  Google Scholar 

  17. Eurostat (2007) Europe in figures. Eurostat Yearbook 2006–2007. Naciones Unidas

  18. Rubio-Terrés C, Ordovás Baines JP, Pla Poblador R, Martínez Nieto C, Sánchez Garre MJ, Rosado Souvirón MA et al (2007) Grupo de Investigadores del Estudio PRAXIS. Use and cost of biological disease-modifying anti-rheumatic drugs in Spain (PRAXIS study). Farm Hosp 31:78–92

    Article  PubMed  Google Scholar 

  19. Carmona L, Villaverde V, Hernández-García C, Ballina J, Gabriel R, Laffon A (2002) EPISER Study Group. The prevalence of rheumatoid arthritis in the general population of Spain. Rheumatology (Oxford) 41:88–95

    Article  CAS  Google Scholar 

  20. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1998) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324

    Article  Google Scholar 

  21. Gonzalez-Gay MA, Gonzalez-Juanatey C, Lopez-Diaz MJ, Piñeiro A, Garcia-Porrua C, Miranda-Filloy JA, Ollier WE, Martin J, Llorca J (2007) HLA-DRB1 and persistent chronic inflammation contribute to cardiovascular events and cardiovascular mortality in patients with rheumatoid arthritis. Arthritis Rheum 57:125–132

    Article  CAS  PubMed  Google Scholar 

  22. Prevoo ML, van’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL (1995) Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48

    Article  CAS  PubMed  Google Scholar 

  23. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA et al (2007) Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 39:1423–1434

    Article  PubMed  Google Scholar 

  24. Ferraz MB, Oliveira IM, Araujo PM, Atra E, Tugwell P (1990) Crosscultural reliability of the physical ability dimension of the health assessment questionnaire. J Rheumatol 17:813–817

    CAS  PubMed  Google Scholar 

  25. Chorus AM, Miedema HS, Boonen A, Van Der Linden S (2003) Quality of life and work in patients with rheumatoid arthritis and ankylosing spondylitis of working age. Ann Rheum Dis 62:1178–1184

    Article  CAS  PubMed  Google Scholar 

  26. Gonzalez-Gay MA, Garcia-Unzueta MT, Berja A, Vazquez-Rodriguez TR, Miranda-Filloy JA, Gonzalez-Juanatey C et al (2009) Short-term effect of anti-TNF-alpha therapy on nitric oxide production in patients with severe rheumatoid arthritis. Clin Exp Rheumatol 27:452–458

    CAS  PubMed  Google Scholar 

  27. Gonzalez-Juanatey C, Llorca J, Vazquez-Rodriguez TR, Diaz-Varela N, Garcia-Quiroga H, Gonzalez-Gay MA (2008) Short-term improvement of endothelial function in rituximab-treated rheumatoid arthritis patients refractory to tumor necrosis factor alpha blocker therapy. Arthritis Rheum 59:1821–1824

    Article  CAS  PubMed  Google Scholar 

  28. Gonzalez-Gay MA, Garcia-Unzueta MT, Berja A, Vazquez-Rodriguez TR, Gonzalez-Juanatey C, de Matias JM et al (2008) Anti-tumour necrosis factor alpha therapy modulates ghrelin in patients with severe rheumatoid arthritis. Ann Rheum Dis 67:1644–1646

    Article  CAS  PubMed  Google Scholar 

  29. Gibbons LJ, Hyrich KL (2009) Biologic therapy for rheumatoid arthritis: clinical efficacy and predictors of response. BioDrugs 23:111–124

    Article  CAS  PubMed  Google Scholar 

  30. Hyrich KL, Watson KD, Silman AJ, Symmons DP (2006) Predictors of response to anti-TNF-alpha therapy among patients with rheumatoid arthritis: results from the British Society for Rheumatology Biologics Register. Rheumatology (Oxford) 45:1558–1565

    Article  CAS  Google Scholar 

  31. Monteiro RDC, Zanini AC (2008) Análise de custo do tratamento medicamentoso da artrite reumatóide. Rev Bras Cienc Farm 44:25–33

    Google Scholar 

  32. Gabriel SE, Colyle D, Moreland LW (2001) A clinical and economic review of disease-modifying antirheumatic drugs. Pharmacoeconomics 19:715–728

    Article  CAS  PubMed  Google Scholar 

  33. McDougall JJ (2006) Arthritis and pain: neurogenic origin of joint pain. Arthritis Res Ther 8:220–230

    Article  PubMed  Google Scholar 

  34. Vlaar AP, ten Klooster PM, Taal E, Gheith RE, El-Garf AK, Rasker JJ et al (2007) A cross-cultural study of pain intensity in Egyptian and Dutch women with rheumatoid arthritis. J Pain 8:730–736

    Article  PubMed  Google Scholar 

  35. Phillips DM (2000) Pain management standards are unveiled. JAMA 284:428–429

    Article  CAS  PubMed  Google Scholar 

  36. Fitzcharles MA, DaCosta D, Ware MA, Shir Y (2009) Patient barriers to pain management may contribute to poor pain control in rheumatoid arthritis. J Pain 10:300–305

    Article  PubMed  Google Scholar 

  37. Kojima M, Kojima T, Suzuki S, Oguchi T, Oba M, Tsuchiya H et al (2009) Depression, inflammation, and pain in patients with rheumatoid arthritis. Arthritis Rheum 61:1018–1024

    Article  PubMed  Google Scholar 

  38. Zautra AJ, Parrish BP, Van Puymbroeck CM, Tennen H, Davis MC, Reich JW, Irwin M (2007) Depression history, stress, and pain in rheumatoid arthritis patients. J Behav Med 30:187–197

    Article  PubMed  Google Scholar 

  39. Sokka T, Häkkinen A (2008) Poor physical fitness and performance as predictors of mortality in normal populations and patients with rheumatic and other diseases. Clin Exp Rheumatol 26:S14–S20

    CAS  PubMed  Google Scholar 

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Acknowledgments

The authors thank the staff and patients of Hospital Xeral-Calde, Lugo (Spain). We especially thank to Dr. Amalia Sanchez-Andrade, Dr. José Alberto Miranda Filloy, Dr. Tomás Ramón Vázquez Rodríguez members of the Rheumatology Division and Mrs. Susana Escandón nurse from the Rheumatology Division of Hospital Xeral-Calde, Lugo (Spain) for the valuable help in the recruitment of the patients. We also thank to Brazilian National Research and Development Council (CNPq) for supporting Dr. Ide fellowship.

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Authors and Affiliations

  1. Universidade Estadual do Oeste do Paraná, Cascavel, PR, Brazil

    Maiza Ritomy Ide, Kelly Cristina Yano, Marcelo Jun Imai & Mario Chueire de Andrade Jr.

  2. Hospital Xeral-Calde, Lugo, Spain

    Miguel A. Gonzalez-Gay

  3. Epidemiology and Computational Biology, School of Medicine and CIBER Epidemiología y Salud Pública, University of Cantabria, Santander, Spain

    Javier Llorca

  4. Rua H27E, n. 113. Campus do CTA, São José dos Campos, SP, Brazil

    Maiza Ritomy Ide

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  1. Maiza Ritomy Ide
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  2. Miguel A. Gonzalez-Gay
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Correspondence to Maiza Ritomy Ide.

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Ide, M.R., Gonzalez-Gay, M.A., Yano, K.C. et al. Functional capacity in rheumatoid arthritis patients: comparison between Spanish and Brazilian sample. Rheumatol Int 31, 221–226 (2011). https://doi.org/10.1007/s00296-009-1282-z

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  • DOI: https://doi.org/10.1007/s00296-009-1282-z

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