The following is a summary of “Disability Related to the Upper Extremities in Early Rheumatoid Arthritis – Long-term Course and Disease Parameter Impact: a cohort study,” published in the October 2024 issue of Rheumatology by Rydholm et al.
Researchers conducted a retrospective study to investigate the progression of upper extremity (UE) disability in early rheumatoid arthritis (RA) and assess the relationships between UE disability and clinical parameters, including grip force.
They assessed UE disability in an inception cohort of patients with early RA (diagnosed 1995-2005, N=222, follow-up 10 years) using a subscore of the Health Assessment Questionnaire Disability Index (HAQ-DI) and measured grip force of the dominant hand. They evaluated changes in the HAQ-DI-UE subscore between follow-up visits and analyzed correlations with key clinical parameters, as well as the relationship between joint involvement and HAQ-DI-UE using multivariate linear regression.
The results showed that the HAQ-DI-UE decreased significantly from inclusion to the 6-month follow-up (mean change -0.26; 95% CI -0.18 to -0.34) but increased significantly after 2 years. There were strong correlations between HAQ-DI-UE and grip force (r: -0.50 to -0.62), patient’s global assessment (r: 0.58 to 0.64), and patient’s assessment of pain (r: 0.54 to 0.60) at all time points through 5 years, while correlations with swollen joints, CRP, and ESR were moderate to weak. At inclusion, wrist synovitis and tender proximal interphalangeal (PIP) joints independently impacted HAQ-DI-UE, whereas tenderness of the shoulder and wrist was more significant at 6 months.
The study concluded that UE disability significantly decreased in the first 6 months but increased again after 2 years, highlighting the critical role of pain and impaired hand function in early rheumatoid arthritis.
Source: jrheum.org/content/early/2024/10/09/jrheum.2024-0608
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